Welcome to the free 2016 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.
How does it work?
- Download one of the above spreadsheets.
- Head to CMS and download the latest 2016 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.
- Extract the PPRRVU16_V1110_V2.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 16, and ends in .xlsx and is larger than 2MB. It will have just under 20,000 CPT codes in it.
- Cut and paste the entire page of data from the PPRRVU16_V1110_V2.xlsx file into the tab marked “PPRRVU16_V1110_V2.xlsx″ in the RVU Calculator spreadsheet. Don’t panic if it seems to freeze for a minute, it’s a lot of data.
- 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.
- 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