Work Relative Value Units Comparison Between Foot and Ankle Surgeries and Other Orthopaedic Procedures: A Propensity...

Area of Science:

• Orthopaedic Surgery
• Health Economics

Background:

• Technical expertise in orthopaedic foot and ankle (FA) procedures is high.
• Compensation adequacy for FA surgeries is largely unexplored.
• This study compares FA surgery compensation to other orthopaedic procedures.

Purpose of the Study:

• To evaluate the compensation adequacy of orthopaedic FA surgeries.
• To compare FA procedures with non-FA procedures based on work relative value unit (wRVU), operative time (OT), wRVU per hour (wRVU/hr), and reimbursement rate ($/hr).

Main Methods:

• Utilized data from the National Surgical Quality Improvement Program (2020-2022).
• Classified procedures as FA or non-FA using Current Procedural Terminology (CPT) codes.
• Employed 1:1 propensity score matching and analysis of covariance to compare groups, controlling for patient demographics and comorbidities.

Main Results:

• FA procedures had longer operative times (96.55 min) than non-FA procedures (86.90 min).
• FA procedures generated significantly lower wRVUs (11.35 vs. 14.40) and wRVU/hr (8.77 vs. 13.51).
• FA procedures resulted in lower reimbursement rates ($382.25/hr vs. $487.65/hr).

Conclusions:

• Orthopaedic FA procedures are systemically undervalued.
• FA surgeries yield lower wRVU/hr and reimbursement rates despite longer operative times.
• Reevaluation of wRVU allocation is needed to reflect the demands of FA surgery.