What Provides the Best Value for Your Time in Spine Surgery? An Analysis of Relative Value Units.

DESIGN

Retrospective database analysis.

OBJECTIVE

This study aims to assess the RVU compensation model for the most common spine surgeries.

BACKGROUND

Physician work is commonly valued by utilizing the relative value unit (RVU) model for compensation. Our aim in this study was to assess RVU and RVU per minute valuations of the most common spine procedures comparing cervical versus lumbar and fusion versus non-fusion cases.

METHODS

The ACS-NSQIP database was utilized to identify the most commonly performed spine procedures. RVU and RVU per minute values were calculated and compared in each group.

RESULTS

In all, 18,779 entries encompassing 28 CPT codes/code combinations were identified. Average RVUs were higher in cervical spine cases compared with lumbar cases (29 vs. 20 RVUs, respectively). Furthermore, cervical cases had significantly higher RVUs per minute compensation compared with lumbar cases (0.26 vs. 0.18 RVUs/min; P =0.01). Fusion cases also fared higher average RVUs compared with nonfusion cases (28 vs. 19 RVUs, respectively). However, when corrected for operative time, fusion cases did not differ significantly in RVUs per minute ( P= 0.13).

CONCLUSIONS

Cervical spine surgery provides the best value for the surgeon in terms of RVUs per minute. We highlight key aspects of the compensation model in spine surgery.

LEVEL OF EVIDENCE: Level III-economic study.