Asthana Shravan, Bajaj Pranav M, Staub Jacob R, Workman Connor D, Reyes Samuel G, Follett Matthew A, Patel Alpesh A, Hsu Wellington K, Divi Srikanth N
Department of Orthopedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Clin Spine Surg. 2025 Mar 1;38(2):E75-E80. doi: 10.1097/BSD.0000000000001660. Epub 2024 Aug 28.
Level 3 retrospective database study.
This study aims to compare work RVU (wRVU), practice expense RVU (peRVU), malpractice RVU (mpRVU), and inflation-adjusted facility price alongside MS-DRG relative weight length of stay (LOS) for cervical spine fusions between 2011 and 2023.
Both RVU and MS-DRG reimbursement have been studied in various surgical subspecialties; however, little investigation has centered on cervical spine fusions. To the best of our knowledge, this is the first study to investigate trends in RVU and MS-DRG reimbursement in cervical spine fusion throughout the COVID-19 pandemic.
Center for Medicaid and Medicare Services (CMS) physician fee schedule was queried between 2011 and 2023 for RVU and facility reimbursement using common single and multilevel anterior and posterior cervical fusion codes. RVU facility prices were inflation adjusted to 2023. MS-DRG reimbursement data from 2011 to 2022 were compiled for cervical spinal fusion procedures with major complication or comorbidity (MCC) 471, complication or comorbidity (CC) 472, and without CC/MCC 473. Compound annual growth rates (CAGRs), Mean Annual Change, and yearly percent changes were calculated.
No changes in wRVU were seen for all cervical CPT codes; however, the CAGR of peRVU (-0.51%±0.60%) and mpRVU (0.69%±0.41%) demonstrated marginal fluctuations. Every CPT code displayed an inflation-adjusted facility price decrease (-2.18%±0.24%). When assessing MS-DRG, there were marginal changes in geometric mean LOS (0.17%±0.45%), arithmetic mean LOS (-0.15%±0.84%), and relative weight (1.09%±0.68%). Unlike RVU reimbursement, the yearly percent change differs between each MS-DRG code.
Inflation-adjusted RVU reimbursement facility prices demonstrated a consistent decrease, while DRG code reimbursement stayed relatively consistent over the study period. This data may help surgeons and hospitals become cognizant of temporal variations in reimbursement patterns as it may affect their personal practice.
Level III retrospective study.
3级回顾性数据库研究。
本研究旨在比较2011年至2023年期间颈椎融合术的工作相对价值单位（wRVU）、执业费用相对价值单位（peRVU）、医疗事故相对价值单位（mpRVU）以及经通胀调整后的机构价格与MS-DRG相对权重住院时长（LOS）。
相对价值单位（RVU）和MS-DRG报销在各种外科亚专业中均有研究；然而，针对颈椎融合术的研究较少。据我们所知，这是第一项在整个新冠疫情期间调查颈椎融合术中RVU和MS-DRG报销趋势的研究。
查询了2011年至2023年医疗保险和医疗补助服务中心（CMS）医师费率表中使用常见的单节段和多节段前路及后路颈椎融合编码的RVU和机构报销情况。将RVU机构价格通胀调整至2023年。汇总了2011年至2022年期间主要并发症或合并症（MCC）为471、并发症或合并症（CC）为472以及无CC/MCC为473的颈椎融合手术的MS-DRG报销数据。计算了复合年增长率（CAGR）、年均变化和年度百分比变化。
所有颈椎CPT编码的wRVU均无变化；然而，peRVU（-0.51%±0.60%）和mpRVU（0.69%±0.41%）的CAGR显示出轻微波动。每个CPT编码的经通胀调整后的机构价格均下降（-2.18%±0.24%）。在评估MS-DRG时，几何平均住院时长（0.17%±0.45%）、算术平均住院时长（-0.15%±0.84%）和相对权重（1.09%±0.68%）有轻微变化。与RVU报销不同，每个MS-DRG编码的年度百分比变化有所不同。
经通胀调整后的RVU报销机构价格呈持续下降趋势，而DRG编码报销在研究期间保持相对稳定。这些数据可能有助于外科医生和医院了解报销模式的时间变化，因为这可能会影响他们的个人业务。
III级回顾性研究。
