Wiki wRVU amount for Category III CPT codes 0479T 0480T

[jrosealex]

My organization is needing to establish "internal" wRVU amounts for 0479T & 0480T. I understand there is no published RVU amount since these are Category III codes. What methodologies are other practices using for these codes? We're considering using wRVUs for CPTs 17110 & 17111 for comparison purposes but would love to get any insight from other professionals. Thanks in advance!

 

[NRaizman]

If those codes are getting paid by any of your major payors or MACs, take that amount, compare to known codes with known RVU values, and use a similar "conversion factor" to back calculate the equivalent RVU's. This is only an approximation because you're looking at Total RVU (PE + Work + Liability), not just Work RVU's. But it is a fairly good approximation for most procedures, as the wRVU should be right around 50% of the Total RVU across the board with limited exceptions for elevated PE expenses.

At some point down the line, the reimbursement "credit" for the surgeon should line up with the procedural reimbursement. The whole point of RVUs and resource based relativity is for there to be a level playing field across specialties and subspecialties.