Correlation Between Relative Value Units and Operative Time for Peripheral Nerve Surgeries.

IF 1.8 Q2 ORTHOPEDICS HAND Pub Date : 2025-01-08 DOI:10.1177/15589447241306149

Anshumi Desai, Yujie Wang, Cheng-Bang Chen, Mehmet Akcin, Kyle Y Xu, Kashyap Komarraju Tadisina

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Abstract

Background: The work relative value unit (wRVU) system quantifies surgeons' effort and resources for procedures. Studies have shown its inaccuracy in capturing the complexity of certain plastic and upper extremity surgeries. Analysis for peripheral nerve surgery (PNS), a growing niche within hand and plastic surgery, has not been performed. The authors aim to evaluate the PNS wRVUs by correlation to their operative time.

Methods: A retrospective analysis with current procedure terminology (CPT) codes for PNS (2005-2021) from the American College of Surgeons National Surgical Quality Improvement Program database was performed. Efficiency was determined by wRVU per operative time. Correlation was performed between operative time with wRVU and wRVU/minute.

Results: A total of 2402 procedures across 21 CPT Codes were included and categorized into neuroplasty, nerve repair, and nerve grafting/transfers with the median operative time being 63.75, 100, and 153.78 minutes respectively. Nerve graft/transfer generated the maximum wRVU (mean 16.35). Neuroplasty generated the minimum wRVU (mean 7.24). Nerve grafts/transfers generated the least wRVUs per minute (0.09). Longer operative times were associated with higher wRVUs. Neuroplasty (R = .86) and nerve repairs (R = .84) had a strong correlation to the operative time. Nerve grafts/transfer had a positive but moderate correlation with the operative time (R = .67). All procedures had a negative correlation between operative time and wRVU/minute.

Conclusions: Nerve grafts/transfers had reduced compensation compared to neuroplasty or nerve repairs. Compensation did not reflect the procedure efficiency. This disparity in wRVU allocation for complex PNS underscores the need for remuneration reform.

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周围神经手术相对价值单位与手术时间的关系。

背景：工作相对价值单位（wRVU）系统量化外科医生的努力和资源的程序。研究表明，它在捕捉某些整形和上肢手术的复杂性方面是不准确的。周围神经手术（PNS），一个日益增长的利基在手外科和整形外科，尚未进行分析。作者的目的是通过与手术时间的相关性来评估PNS wRVUs。方法：回顾性分析美国外科医师学会国家手术质量改进计划数据库中PNS的现行手术术语（CPT）代码（2005-2021）。效率由每次手术时间的wRVU确定。手术时间与wRVU值与wRVU/min值进行相关性分析。结果：共纳入21个CPT规范的2402例手术，分为神经成形术、神经修复术和神经移植/转移术，平均手术时间分别为63.75分钟、100分钟和153.78分钟。神经移植/移植产生最大的wRVU（平均16.35）。神经成形术产生最小的wRVU（平均7.24）。神经移植/移植物每分钟产生的wRVUs最少（0.09）。较长的手术时间与较高的wrvu相关。神经成形术（R = 0.86）和神经修复（R = 0.84）与手术时间有很强的相关性。神经移植物/转移与手术时间呈正相关（R = 0.67）。手术时间与wRVU/min呈负相关。结论：与神经成形术或神经修复相比，神经移植/神经转移具有较低的代偿性。补偿没有反映程序效率。在分配给复杂的国家方案支助额方面的差距突出了薪酬改革的必要性。

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来源期刊

HAND Medicine-Surgery

CiteScore

3.30

自引率

0.00%

发文量

209

期刊介绍： HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.