Pediatric Benchmarks for RVU Rate by Procedure Type

February 16, 2011

benchmarks

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.

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Pediatric Benchmarks for RVU Rate by Procedure Type

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