American Association of Plastic Surgeons

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Correlation Between Relative Value Units And Operative Time For Craniofacial Surgeries
Anshumi Desai, MD, Nicholas A. Mirsky, BS, Yujie Wang, PhD, Cheng-Bang Chen, PhD, Mehmet Akcin, PhD, Paulo G. Coelho, MD, DDS, PhD, MBA, Kashyap K. Tadisina, MD, Lauren Yarholar, MD.
University of Miami Miller School of Medicine, Miami, FL, USA.

Purpose: Work relative value units (wRVUs) are metrics for surgical reimbursement, yet they may inadequately reflect complexity in craniofacial surgery, a field requiring extensive multidisciplinary planning and technical skill. This study examines the correlation between wRVUs and operative time for craniofacial surgeries, aiming to highlight compensation disparities.
Methods: A retrospective analysis of craniofacial surgery CPT codes from the ACS NSQIP database (2005-2021) assessed wRVUs per unit of operative time across 82 CPT codes (9,628 procedures). Procedures were grouped (e.g., cleft surgery, cranial reconstruction) to analyze correlations between operative time and wRVU per minute.
Results: Cranial reconstruction had the highest median operative time (142.36 min) and wRVU (22.36), while craniofacial mass surgeries had the lowest operative time (50.87 min) and wRVU (8.54). Across categories, longer operative times correlated with increased wRVUs, yet efficiency (wRVU per minute) displayed varied correlations. Specifically, cranial reconstruction and facial trauma procedures exhibited moderate negative correlations to wRVU per minute, underscoring inefficiencies in compensation per operative time.
Conclusions: Craniofacial surgeries, cranial reconstruction and facial trauma repair, experience reduced wRVU per time unit, indicating a need for reimbursement reform. Accurate wRVU alignment with surgical complexity is essential to ensure fair compensation and maintain quality care within the craniofacial specialty.


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