A total of 190,322 non-emergent urologic procedures were identified with RVUs ranging from 4.62 for transurethral resection of small bladder tumor to 44.26 for radical cystectomy with neobladder. On average, RVUs poorly correlated with LOS (R2 = 0.16), and mortality (R2 = 0.04). There was a moderate correlation between RVUs and operative time (R2 = 0.55) and morbidity (R2 = 0.44). RVUs were significant predictors of SAEs (RR = 1.082, 95% CI: 1.081 – 1.083) and unplanned readmissions (RR = 1.057, 95% CI: 1.055 – 1.059).
In the field of urology, certain measures of surgical complexity and overall physician workload appear to correlate with RVUs, while other measures do not. RVUs for individual CPT codes should be reassigned using a data-driven approach. Such high value based care and approach to global cost of care will be the future of medicine and these findings suggest further research needed.
Presented By: Case M. Wood, University of North Carolina, Chapel Hill, North Carolina
Written by: Stephen B. Williams, MD., Associate Professor, Division of Urology, The University of Texas Medical Branch, Galveston, TX. and Ashish M. Kamat, MD. Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX at the 2018 American College of Surgeons Clinical Congress, October 21-25, 2018 in Boston, Massachusetts