ArticleThe Iowa orthopaedic journal2020
Misvaluation of Hospital-Based Upper Extremity Surgery Across Payment, Relative Value Units, and Operative Time.
Article in The Iowa orthopaedic journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 9 citations in OpenAlex.
- Economic Barriers to Interventional Cardiology Care for Adults and Children With Congenital Heart Disease and Potential Policy Solutions: A SCAI Policy Statement.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- Financial incentives and work relative value unit comparison of fixation versus total elbow arthroplasty for distal humerus fractures.Clinics in shoulder and elbow · 2025Article
- Comparison of current relative value unit-based prices and utility between common surgical procedures, including orthopedic surgeries, in South Korea.Cost effectiveness and resource allocation : C/E · 2024Article
- Are Orthopedic Hand Surgeons Undercompensated for Time Spent in the Operating Room? A Study of Relative Value Units.Hand (New York, N.Y.) · 2023Article
- Variation in Estimated Surgical Procedure Times Across Patient Characteristics and Surgeon Specialty.JAMA surgery · 2022Article
- Primary versus revision total shoulder arthroplasty: comparing relative value and reimbursement trends.Clinics in shoulder and elbow · 2022Article
- Work relative value units and perioperative outcomes in patients undergoing brain tumor surgery.Neurosurgical review · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Many US health care institutions have adopted compensation models based on work relative value units (wRVUs) to standardize payments and incentivize providers. Among other factors, a major determinant of payment and wRVU assignments is operative time. Our objective was to determine whether differences in estimated operative times between the Centers for Medicare & Medicaid Services (CMS) and the National Surgical Quality Improvement Program (NSQIP) contribute to payment and wRVU misvaluation for the most common hospital-based hand and upper extremity procedures. Methods: Data on wRVUs, surgeon payment, and estimated operative times were collected from CMS for 53 procedures. We used regression models to compare relationships between these variables, in addition to actual median operative times as reported in the NSQIP database, from 2011 to 2016. We then determined the relative valuation of each procedure based on operative time. Results: There was a wide discrepancy between CMS and NSQIP operative times (R Conclusions: CMS may misvalue payment and wRVU rates of hospital-based hand procedures due to inaccurate operative time estimates. By identifying which procedures are misvalued in terms of payment and wRVU per operative time, providers and payors may be able to address these imbalances and maximize appropriate care delivery incentives.
Indexed as
Identifiers
32742227PMC7368537W3048000294What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.