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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

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