Free 2015 RVU Calculator

Welcome to the free 2015 RBRVS Calculator.

As you may know, the AMA won’t let anyone provide a free RVU calculator that includes CPT codes due to their CPT copyrights. In an abundance of caution and, because in our unhappy experience, the AMA interprets its rights (in our opinion) overly broadly, we created this tool for those of you who have a CPT license that allows for a use such as this. In theory, that should mean any practice that submits insurance claims.

To make a long story short, you can use this spreadsheet with the data that you can download from CMS to make a fairly sophisticated RVU calculator in about 5 minutes. This will allow you to fairly set your prices, analyze a payer contract, or double-check your expected payments.  It also lets you perform a lot of other analysis tricks that the cool kids can figure out.

What does it do, technically? It allows you to choose your CMS-driven location, set a Medicare Multiplier, and then, on a code-by-code basis, determine your pricing level. If you then take the time to include your code volume and pricing, it will determine your practice’s FACF (i.e., how much you charge, on average, relative to Medicare). If you then provide your payment information, it will compare them to the Medicare fee schedule for you.

As of this writing, I have created an OpenOffice version. The Excel version is finished, but I need testers. I don’t trust Excel.  [Update: the OpenOffice version is updated to address the longer CPT code list; I need to finish the Excel version.]

How does it work?

  1. Download one of the above spreadsheets.
  2. Head to CMS and download the latest 2015 RVU zip file. (This link brings you to the January 2015 release; be on the look out for newer versions.) You have to agree to the license and usage rules from CMS, of course.
  3. Extract the PPRRVU15_V1223c.xlsx file from the zip file. Note that the actual file name will change based on version of the RVU data file you download. You are essentially looking for a file that begins with “PPRVU,” has the number 15, and ends in .xlsx and is larger than 2MB.
  4. Cut and paste the entire page of data from the PPRRVU15_V1223c.xlsx file into the tab marked “PPRRVU15_V1223c.xlsx″ in the RVU Calculator spreadsheet. Don’t panic if it seems to freeze for a minute, it’s a lot of data.
  5. Go back to the first tab.  Choose your locality with the pulldown menu. Pick a Medicare Multiplier. Then, enter some CPT codes in column A. Gasp in amazement.
  6. Put some unit volumes, prices, and payments in and watch what happens. Any field marked in a light blue-gray is a place where you can enter info.

I’d love for some guinea pigs to try this out and tell me what doesn’t work. PCC clients, natch, can do this already with our reports, so I want to hear from the rest of you :-)

15 thoughts on “Free 2015 RVU Calculator

  1. Rats. I was unable to get either version (OpenOffice or Excel) to work. OpenOffice did not do anything when I loaded the CPT codes in the 2nd tab. Excel had REF# in every cell except the ones I was supposed to populate. When I populated them the REF# stayed in place.

    • No – my world is focused just on those independent pediatric practices. I figure the surgeons can take care of themselves 🙂

      It would take very little effort, however, to edit the spreadsheet to look at the facility figures instead of the non-facility figures. I didn’t lock down the form so you can see all of the formulas.

  2. not a billing person but was asked to find an RVU calculator. Got everything set up but was wondering about the Medicare Multiplier. Can you tell me more about that and where I begin looking for it? Or is the 175 already in the cell sufficient?

    • The multiplier is up to you – it’s just the level at which you want to look at pricing relative to Medicare. If you put it 100%, you’ll see CMS rates. If you put it at 350%, you’ll see hospital rates. If you put it at 75%, you’ll see what United pays primary care (just kidding. kind of.).

      Ultimately, you should use a multiplier that makes sense in the context of your practice.

      • Chip,

        Is there a public source to be able to benchmark the Medicare multiplier? Can the multiplier be obtained be obtained from provider or payer information?

        • Brandon, I think I need a little more information to be helpful.

          If you are talking about the actual Medicare Conversion Factor – the one CMS uses – that’s a matter of public record and part of the RVU data.

          If you are talking about the percentage at which most practices multiple the Medicare rate to set their prices, that is VERY specialty specific (though it shouldn’t be). I can tell you that PCC clients are in the 170% area, but other specialties are between 200-400%. Most pediatricians are < 150%, imo. Let me know if you need more info.

  3. Pingback: 2008 RVU Spreadsheet and Calculator Complete | Confessions of a Pediatric Practice Management Consultant

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