PURPOSE:
The Work relative value units (wRVUs) system was developed and established in 1992 as a quantifier of physician labor, technical skill, medical decision making, and training time required to complete surgical procedures. Our purpose was to highlight the discrepancies between microsurgical reconstructive and aesthetic procedures based upon dollar/unit time.
METHODS:
We performed a retrospective analysis of data from the 2020 ACS NSQIP participant use data files to identify average length of Operative Room time for procedures for 8 reconstructive microsurgery and 3 aesthetic procedures.Aesthetic Plastic Surgery National Databank Procedural Statistics Report 2020-2021 and Novitas - CMS Centers for Medicare and Medicaid Services were utilized to identify the average reimbursement for the above procedures. RVU data were assessed using the 2020 PFS. For each procedure, work RVU. RVU per unit time data were calculated using the median operative time and average reimbursement per unit time for each procedure. RESULTS:
Our results show that the average rate of reimbursement for microsurgical reconstructive cases was $6.72 per minute, with an average surgical operative time of 233.52 minutes (about 4 hours) per case. In contrast, the average rate of reimbursement for aesthetic cases was $31.99 per minute, with an average surgical operative time of 150.23 minutes (about 2 and a half hours) per case. This difference in remuneration translates to a 4.7x difference.
CONCLUSION:
Complexity and time are not directly related to compensation, and the inequalities in compensation within the same specialty are something reconstructive plastic surgeons should be aware of.