Jared M. Newman

Are We Appropriately Compensated by Relative Value Units for Primary vs Revision Total Hip Arthroplasty

BACKGROUNDnRelative value units (RVUs) are used to evaluate the effort required for providing a service to patients in order to determine compensation. Thus, more complicated cases, like revision arthroplasty cases, should yield a greater compensation. However, there are limited data comparing RVUs to the time required to complete the service. Therefore, the purpose of this study is to compare the (1) mean RVUs, (2) mean operative times, and (3) mean RVU/minute between primary and revision total hip arthroplasty (THA) and (4) perform an individualized idealized surgeon annual cost difference analysis.nnnMETHODSnA total of 103,702 patients who underwent primary (current procedural terminology code 27130) and 7273 patients who underwent revision THA (current procedural terminology code 27134) were identified using the National Surgical Quality Improvement Program database. Mean RVUs, operative times (minutes), and RVU/minute were calculated and compared using Student t-test. Dollar amount per minute, per case, per day, and year was calculated to find an individualized idealized surgeon annual cost difference.nnnRESULTSnThe mean RVU was 21.24 ± 0.53 (range, 20.72-21.79) for primary and 30.27 ± 0.03 (range, 30.13-30.28) for revision THA (P < .001). The mean operative time for primary THA was 94 ± 38xa0minutes (range, 30-480xa0minutes) and 152 ± 75xa0minutes (range, 30-475xa0minutes) for revision THA (P < .001). The mean RVU/minute was 0.260 ± 0.10 (range, 0.04-0.73) for primary and 0.249 ± 0.12 (range, 0.06-1.0) for revision cases (P < .001). The dollar amounts calculated for primary vs revision THA were as follows: per minute (

A Comparison of Relative Value Units in Primary Versus Revision Total Knee Arthroplasty

9.33 vs

New alternate bearing surfaces in total hip arthroplasty: A review of the current literature

8.93), per case (

Impact of Intravenous Acetaminophen on Lengths of Stay and Discharge Status after Total Knee Arthroplasty

877.12 vs

Nerve injuries associated with total hip arthroplasty

1358.32), per day (

What provides a better value for your time? The use of relative value units to compare posterior segmental instrumentation of vertebral segments

6139.84 vs

Parkinson’s disease increases the risk of perioperative complications after total knee arthroplasty: a nationwide database study

5433.26), and a projected

Total shoulder arthroplasty in octogenarians: Is there a higher risk of adverse outcomes?

113,052.28 annual cost difference for an individual surgeon.nnnCONCLUSIONnMaximizing the RVU/minute provides the greatest hourly rate. The RVU/minute for primary (0.260) being significantly greater than revision THA (0.249) and an annualized

Comparing psychological burden of orthopaedic diseases against medical conditions: Investigation on hospital course of hip, knee, and spine surgery patients

113,052.28 cost difference reveal that although revision THAs are more complex cases requiring longer operative time, greater technical skill, and aftercare, compensation per time is not greater.

Does the Robotic Arm and Preoperative CT Planning Help with 3D Intraoperative Total Knee Arthroplasty Planning

BACKGROUNDnIn total knee arthroplasty (TKA), revision cases are often technically more challenging, and require more operative time and aftercare than primary cases. These time and effort differences should therefore be appropriately compensated for when using the relative value unit (RVU) system. Therefore, the purpose of this study is to compare the mean (1) RVUs; (2) operative times; and (3) RVU/min; and (4) perform an individualized idealized surgeon annual cost difference analysis for primary vs revision TKA.nnnMETHODSnCurrent Procedural Terminology code 27447 identified 165,439 primary TKA patients, while Current Procedural Terminology code 27487 identified 8081 revision TKA patients from the National Surgical Quality Improvement Program database. The mean RVUs, operative times, and RVU/min were calculated. Dollar amount per minute, per case, per day, and year were also calculated. Students t-test, with a cut-off P-value of <.05, was used in order to identify any statistical differences in mean RVUs, operative times, and RVU/min.nnnRESULTSnThe mean RVUs for primary TKA was 22, while for revision TKA was 27 (P < .001). The mean operative time for primary TKA was 94 minutes, while for revision TKA was 149xa0minutes (P < .001). The mean RVU/min for primary TKA was 0.26, while for revision TKA was 0.22 (P < .001). The dollar amounts calculated for primary vs revision TKA were per minute (