Question
Sample RVUs for selected HCPCS Codes HCPCS Code Description Work RVU Practice Expense RVU Malpractice Expense RVU 99203 Office Visit 1.23 0.48 0.09 99204 Office
Sample RVUs for selected HCPCS Codes
HCPCS Code | Description | Work RVU | Practice Expense RVU | Malpractice Expense RVU |
---|---|---|---|---|
99203 | Office Visit | 1.23 | 0.48 | 0.09 |
99204 | Office Visit | 2.00 | 0.71 | 0.12 |
10080 | I&D of pilonidal cyst, simple | 1.17 | 1.11 | 0.11 |
45380 | Colonoscopy with biopsy | 4.43 | 1.73 | 0.35 |
52601 | TURP, complete | 12.35 | 5.1 | 0.87 |
Sample GPCIs for selected U.S. Cities
City | Work GPCI | Practice Expense GCPI | Malpractice Expense GCPI |
---|---|---|---|
Indianapolis | 1.000 | 0.946 | 0.941 |
Austin | 1.010 | 1.063 | 1.061 |
Pittsburgh | 1.010 | 1.115 | 0.819 |
Helena | 1.020 | 1.098 | 1.386 |
a. How much can a physician in Indianapolis bill Medicare for an office visit for a new patient with a detailed history and physical and low-complexity medical decision making (assuming the patient has met any deductible for the year?) Assume a conversion factor of $34.0682
b. In which city would a physician receive the highest reimbursement for a TURP?
c. In which city would a physician receive the lowest reimbursement for a colonoscopy with biopsy?
d. Calculate the expected payment for an incision and drainage of a pilonidal cyst in each of the cities listed. Conversion factor: $34.0682
Step by Step Solution
There are 3 Steps involved in it
Step: 1
Get Instant Access to Expert-Tailored Solutions
See step-by-step solutions with expert insights and AI powered tools for academic success
Step: 2
Step: 3
Ace Your Homework with AI
Get the answers you need in no time with our AI-driven, step-by-step assistance
Get Started