The work RVU calculator provides quick analysis of work relative value units associated with CPT® and HCPCS Level II codes. By entering the appropriate code and number of units associated with it, you will receive the total work RVUs and individual work RVU value for that code. The RVU calculation results are based on the values supplied by CMS in the 2020 National Physician Fee Schedule Relative Value File.
The Importance of RVUs
Work RVUs are the most frequently utilized component of the Resource-Based Relative Value Scale (RBRVS). Different from practice expense RVUs and malpractice RVUs, work RVUs—based on wage data for seven specialty occupation categories—provide a measure of the physician work involved with performing a service or procedure represented by a CPT® or HCPCS Level II code.
In the 2020 the Medicare Physician Fee Schedule (MPFS), work RVUs range from 0.1 for CPT® code 70300 Radiologic examination, teeth; single view to 108.91 for CPT® code 39503 Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia.
On a common scale, physician work RVUs compare the work involved with performing a service to all other services and procedures. For example, removing a foreign body from an eye (CPT® code 65205) is assigned 0.49 work RVUs. But performing a minor eye wound repair (65270) is valued at 1.95 work RVUs. The work required to repair the eye wound, then, is 4 times greater than the work involved with the foreign body removal.
What measures are included in work RVUs?
Work RVUs assess physician labor on several levels—accounting for technical skill, physical effort, mental effort, judgment, and stress related to patient outcome. But perhaps the most crucial component factored into work RVUs is the time required to perform a service.
Total work involved in a service or procedure refers to 3 stages of work, each associated with a unit of time:
- Pre-service work refers to work provided before the service or procedure (e.g., reviewing records, discussing procedures with peers, preparing for surgery).
- Intra-service work refers to work involved in providing the service or performing the procedure. The intra-service period is defined as patient encounter time for an office visit, or the time spent on the patient’s floor for a hospital visit. With surgical procedures, the intra-service time, also called “skin-to-skin” time, is defined as the period between making the first incision and closing the incision.
- Post-service work includes all related work provided after the service is delivered (e.g., post-op care, patient stabilization, recovery room care, updating documentation).
For surgical procedures, the total work period is the same as the global surgical period, including recovery-room time, normal postoperative hospital care, and office visits after discharge, as well as pre-operative and intra-operative work.
All work RVUs assigned to codes express total work and offer a quantitative measure of the time involved with delivering the service.
Prior to the introduction of the Resource-Based Relative Value Scale (RBRVS), the only means to track a provider’s productivity was to count the number of patients the physician saw and the procedures he or she performed. This method proved ineffective, offering little more than volume measurements, considering that the work involved in delivering each service varies dramatically.
The number of relative value units generated by a physician is currently the best means available to measure a physician’s productivity. As such, RVUs have become a standard provider compensation model. Although compensation, as defined in employment agreements, differs in terms of RVU thresholds and dollars per RVU, the general intent of the RVU model is to pay physicians based on the amount of work performed, regardless of the payer mix or amount of revenue generated.
CPT codes are copyright 2019 American Medical Association.
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