---
title: Impact of 2023 RVU Values on Pediatricians
description: Let's compare the 2023 RVU values weighted for a typical pediatric practice to the 2022 and 2020 value sets.  What do we learn?
image: https://chipsblog.pcc.com/hubfs/shutterstock_1759350446.jpg
---

# Impact of 2023 RVU Values on Pediatricians

December 6, 2022

[rvu](https://chipsblog.pcc.com/tag/rvu)

Every year, I analyze the impact of the RVU changes on pediatricians. Why? Because what the Feds do each year has a profound, downstream effect on pediatricians.  Going through this process is also [how I figured out what was happening with immunization administration codes](https://chipsblog.pcc.com/the-negative-impact-of-the-2019-rbrvs-on-pediatricians) in 2018,  and helps me counsel many practices working on fee schedule offers from the payers.

The results going back the last few years have been a mixed bag  for pediatricians, but we have some good news for 2023.  Before we begin, though, it's important to recognize what a watershed moment [2021](https://chipsblog.pcc.com/impact-of-2021-rvus-on-pediatricians) was for pediatricians and primary care in general.  The Feds moved so much value into primary care RVUs (namely through massive improvements to E&M valuation that you really can't talk about RVUs broadly without knowing whether you're referring to pre- or post-2021.. 

However, pediatricians have largely been isolated from these improvements - why?  Because pediatricians don't take Medicare and commercial payors know that a move to 2021 RVU values for pediatricians represents a serious payment improvement.  But they can't avoid it forever.

Maybe the interesting news in 2023 will make a difference.  Let's look.

First, a review of my methodology:

- I start by grabbing the full CPT utilization of our customers to determine which RVU-valid codes (i.e., codes with RVU values) have real impact on pediatric revenue. I want to know how these changes will affect a *typical pediatrician.  *In 2021 (because I can't use 2022, yet), that amounts to just under 250 CPT codes that make up 99%+ of pediatric revenue and about 100 that represent most of the RVUs. Our sample crossed the billion dollar threshold a few years back, so it's a decent data set.
- Using mildly proprietary math, I distribute those codes based on what I'd consider to be the most typical FTE arrangement. In other words, imagine a pediatrician with about 4000 visits a year - how many 99213s would that be, how many screenings, etc.? Every practice and every pediatrician is different, of course, but it is helpful to have a baseline from which to predict.  **N.B.:** the sick:well ratio for 2021 was more historically typical than 2020 for COVID-obvious reasons, so I think we're back on track.
- I then plugged in the 2023 RVU data, using a neutral GPCI and 100% of Medicare rates, and compared it to both the 2020 and 2022 data. Which codes change the most - and which codes, by virtue of their pediatric volume - have the biggest impact? Where do we land?  Why compare to two previous years, skipping one in the middle?  Because 2020 represents the pre-E&M shift made by the Feds and we also want to compare to last year.

**The results for 2023?**

- Headline: I estimate that 2023 will increase pediatric RVUs by about 2.8% over 2022 and 16.6% over 2020.   Payments, on the other hand,  tell a different story.  2023 payments may be 7% higher than 2020, but they are actually lower than 2022 by about 2%.    
  To summarize: 2023 is still markedly better than 2020 or any year before it, but not as good, overall, as 2022.  
- Wait, how can the RVUs in 2023 be higher than 2022 but the expected payments lower?  Because the annual Medicare Conversion Factor - the amount Medicare pays per-RVU - has dropped considerably, from $34.61 (2022) to $33.06 (2023).  This is required to keep the Medicare budget neutral, not some conspiracy to reduce payments.  The Feds shifted billions to primary care, but to do that they have take a little off the top everywhere else.
- Note: [Don't forget to adjust by your GPCI](https://chipsblog.pcc.com/2021-rbrvs-gpci-analysis)!  I haven't done the 2023 numbers yet, so stay tuned.
- To put this in perspective, the implication is that an FTE pediatrician would see an increase of about $38,000 in revenue in 2023 using 2021's volume and 2023's RVU values.  Note, *that's not how this works*, but it's an encouraging result!
- The AAP's strong work to restore immunization administration values, especially in this pandemic era, has really paid off.  The 90460's RVUs are 168% of the 2020 values and the revenue is 153% of 2020.  Similar, though more mild, improvements have been made for the 90471, 90472.  *However, *the 90461 has been cut considerably (almost 25%), offsetting the 90460 improvement.  Don't panic, as the result is still quite net positive.  A practice with a typical 90460/90461/90471/90472 distribution would still see an overall revenue improvement of about 25%, which is fantastic.
- There are other small changes in other pediatric corners - vision screening, hospital visits - but the imms admins are the real story.

The bottom line?  Practices working on their insurance contracts should heartily avoid RBRVS-based contracts based in years 2018-2020.  Anything from 2021 on looks good. 2023 looks the best so far.  Given the slightly lower benefit from 2023 vs. 2022, you *just might* have more luck convincing Aetna or UHC or one of the other similar-to-organized-crime organizations to jump to the 2023 RVU schedule.

Let's see what the changes look like.  Below is a list of the top ~99 RVU-valid codes for pediatricians and what their changes look like for both RVUs and $$, comparing 2023 to both 2022 and 2020.   So, below...the 2023 RVUs for 10060 are 9% higher than 2020 and the revenue is even.  For 2022 -> 2023, the difference is 102% and 97%, respectively.  

| **CPT** | **2023-2020 RVU Delta** | **2023-2020 $$ Delta** | **2023-2022 RVU Delta** | **2023-2022 $$ Delta** |
| --- | --- | --- | --- | --- |
| 10060 | 109% | 100% | 102% | 97% |
| 10120 | 105% | 96% | 102% | 97% |
| 12011 | 107% | 98% | 101% | 96% |
| 17110 | 108% | 99% | 101% | 97% |
| 17250 | 109% | 100% | 98% | 94% |
| 36410 | 106% | 97% | 100% | 96% |
| 41010 | 110% | 101% | 100% | 96% |
| 51701 | 104% | 95% | 100% | 96% |
| 54150 | 101% | 92% | 100% | 96% |
| 67218 | 104% | 95% | 101% | 97% |
| 69200 | 104% | 96% | 101% | 97% |
| 69209 | 115% | 105% | 102% | 98% |
| 69210 | 104% | 96% | 101% | 97% |
| 71046 | 110% | 101% | 101% | 96% |
| 86580 | 115% | 106% | 97% | 92% |
| 90460 | 168% | 153% | 137% | 131% |
| 90461 | 83% | 76% | 81% | 77% |
| 90471 | 150% | 137% | 122% | 117% |
| 90472 | 119% | 109% | 116% | 111% |
| 90473 | 123% | 112% | 100% | 96% |
| 90474 | 97% | 89% | 95% | 90% |
| 90791 | 128% | 117% | 100% | 95% |
| 90834 | 113% | 103% | 99% | 95% |
| 90837 | 111% | 101% | 100% | 95% |
| 90847 | 99% | 91% | 100% | 96% |
| 92551 | 109% | 100% | 106% | 101% |
| 92552 | 119% | 109% | 107% | 102% |
| 92567 | 109% | 100% | 100% | 96% |
| 92583 | 119% | 109% | 109% | 104% |
| 92587 | 103% | 95% | 100% | 96% |
| 94010 | 80% | 73% | 101% | 97% |
| 94060 | 69% | 63% | 100% | 96% |
| 94640 | 54% | 49% | 82% | 78% |
| 94664 | 109% | 99% | 102% | 97% |
| 94760 | 100% | 92% | 100% | 96% |
| 95004 | 100% | 92% | 100% | 96% |
| 95117 | 117% | 107% | 103% | 98% |
| 95165 | 110% | 101% | 98% | 93% |
| 95930 | 105% | 96% | 102% | 98% |
| 96110 | 114% | 105% | 103% | 99% |
| 96112 | 96% | 88% | 100% | 96% |
| 96116 | 100% | 91% | 99% | 95% |
| 96121 | 94% | 86% | 97% | 93% |
| 96127 | 100% | 92% | 100% | 96% |
| 96132 | 102% | 93% | 100% | 96% |
| 96133 | 103% | 94% | 98% | 94% |
| 96160 | 114% | 105% | 100% | 96% |
| 96161 | 114% | 105% | 100% | 96% |
| 96372 | 105% | 96% | 100% | 96% |
| 97802 | 103% | 94% | 101% | 96% |
| 97803 | 103% | 95% | 101% | 97% |
| 99173 | 113% | 103% | 100% | 96% |
| 99174 | 113% | 103% | 106% | 101% |
| 99177 | 108% | 99% | 100% | 96% |
| 99188 | 100% | 92% | 100% | 96% |
| 99202 | 100% | 92% | 100% | 96% |
| 99203 | 110% | 101% | 101% | 97% |
| 99204 | 107% | 98% | 101% | 96% |
| 99205 | 111% | 102% | 101% | 96% |
| 99211 | 106% | 97% | 101% | 97% |
| 99212 | 131% | 120% | 101% | 97% |
| 99213 | 127% | 116% | 101% | 96% |
| 99214 | 124% | 113% | 101% | 97% |
| 99215 | 129% | 118% | 100% | 96% |
| 99221 | 85% | 78% | 85% | 81% |
| 99222 | 99% | 91% | 98% | 94% |
| 99223 | 90% | 82% | 90% | 86% |
| 99232 | 115% | 105% | 114% | 109% |
| 99233 | 120% | 110% | 119% | 114% |
| 99238 | 116% | 106% | 115% | 110% |
| 99239 | 112% | 103% | 112% | 107% |
| 99242 | 88% | 81% | 88% | 84% |
| 99243 | 97% | 88% | 96% | 92% |
| 99244 | 92% | 84% | 92% | 88% |
| 99245 | 98% | 90% | 98% | 94% |
| 99354 | 0% | 0% | 0% | 0% |
| 99381 | 103% | 95% | 101% | 96% |
| 99382 | 103% | 94% | 101% | 96% |
| 99383 | 102% | 94% | 101% | 96% |
| 99384 | 102% | 93% | 99% | 95% |
| 99385 | 102% | 94% | 100% | 95% |
| 99391 | 102% | 94% | 100% | 96% |
| 99392 | 103% | 94% | 101% | 96% |
| 99393 | 103% | 94% | 101% | 96% |
| 99394 | 102% | 94% | 100% | 96% |
| 99395 | 102% | 94% | 101% | 96% |
| 99401 | 103% | 94% | 101% | 96% |
| 99402 | 101% | 92% | 98% | 94% |
| 99403 | 101% | 93% | 100% | 95% |
| 99404 | 101% | 92% | 98% | 94% |
| 99460 | 101% | 93% | 100% | 95% |
| 99462 | 102% | 93% | 99% | 95% |
| 99463 | 103% | 95% | 102% | 97% |
| 99464 | 102% | 93% | 100% | 95% |
| 99477 | 101% | 93% | 100% | 95% |
| G0439 | 118% | 108% | 100% | 96% |
| G0444 | 108% | 99% | 102% | 97% |
| G0447 | 103% | 94% | 99% | 94% |

 

Share: [Email ](mailto:?body=https://chipsblog.pcc.com/impact-of-2023-rvu-values-on-pediatricians) Facebook [Twitter ](https://twitter.com/intent/tweet?url=https://chipsblog.pcc.com/impact-of-2023-rvu-values-on-pediatricians&text=Impact%20of%202023%20RVU%20Values%20on%20Pediatricians) LinkedIn

## Comments

1 Comment

# Subscribe to Chip's Blog

```json
{
  "@context" : "https://schema.org",
  "@type" : "BlogPosting",
  "author" : {
    "@type" : "Person",
    "name" : "Chip Hart",
    "url" : "https://chipsblog.pcc.com/author/chip-hart"
  },
  "dateModified" : "2022-12-06T20:12:35.942Z",
  "datePublished" : "2022-12-06T20:12:35.000Z",
  "headline" : "Impact of 2023 RVU Values on Pediatricians",
  "image" : [ "https://chipsblog.pcc.com/hubfs/shutterstock_1759350446.jpg" ],
  "mainEntityOfPage" : {
    "@id" : "https://chipsblog.pcc.com/impact-of-2023-rvu-values-on-pediatricians",
    "@type" : "WebPage"
  },
  "publisher" : {
    "@type" : "Organization",
    "logo" : {
      "@type" : "ImageObject",
      "url" : "https://chipsblog.pcc.com/hubfs/confessions.png"
    },
    "name" : "Chip's Blog"
  }
}
```