Pediatric Benchmarks for RVU Rate by Procedure Type

Thanks to the impetus provided by an inspired comment on the previous blog entry, Igor and I got excited about the idea of analyzing the average RVU rate for all CPT codes, broken down by procedure type.  Are “well codes” paid at the same rate as “sick codes?”  What about hospital visits?  Imms Admin?

Well, we calculated it for you, and the results are fascinating.

If you must have the procedures broken down in a different way, let me know.  My thanks to I♥DAVETAYLOE and Igor on this one. (This is all charges from PCC peds clients from 11/1/09 – 10/31/10, including unpaid charges.)

Description CPT Code Range % of 2010 Medicare
Sick Visits 99201-99215 92%
Well Visits 99381-99396 107%
Imm Admin 90465-90468,90471-90474 89%
Developmental Screening 96110-96111 166%
Burn Treatment 16000, 16020, 17250, 30901 87%
Circumcision Codes 54150-54161 91%
Wart Removal 17110-17111 95%
Foreign Body Removals 30300-30320, 69200, 10120,10060 87%
Laceration Repair 11040, 11041, 12001-13160 93%
Orthopedic Procedures (incl. Nursemaid’s Elbow) 20100-29999 90%
Vision or Hearing Screening 92583, 92551-92552, 99173, S0302 114%
Consultations 99241-99245, 99251-99255 91%
Newborn Hospital Visits 99431-99433,99460-99463 121%
Hospital Visits 99470-99489, 99220-99269 94%
Counseling Visits 99400-99409 30%

I’ll give someone else here the first stab at commentary, but I won’t sit on my hands for long.

Leave a Reply