Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Dec 1:10:40.
doi: 10.14444/3040. eCollection 2016.

Paired Comparison Survey Analyses Utilizing Rasch Methodology of the Relative Difficulty and Estimated Work Relative Value Units of CPT® Code 27279

Morgan Lorio  1 , Melissa Martinson  2 , Lisa Ferrara  3
Affiliations

Paired Comparison Survey Analyses Utilizing Rasch Methodology of the Relative Difficulty and Estimated Work Relative Value Units of CPT® Code 27279

Morgan Lorio et al. Int J Spine Surg. .

Abstract

Background: Minimally invasive sacroiliac joint arthrodesis ("MI SIJ fusion") received a Category I CPT® code (27279) effective January 1, 2015 and was assigned a work relative value unit ("RVU") of 9.03. The International Society for the Advancement of Spine Surgery ("ISASS") conducted a study consisting of a Rasch analysis of two separate surveys of surgeons to assess the accuracy of the assigned work RVU.

Methods: A survey was developed and sent to ninety-three ISASS surgeon committee members. Respondents were asked to compare CPT® 27279 to ten other comparator CPT® codes reflective of common spine surgeries. The survey presented each comparator CPT® code with its code descriptor as well as the description of CPT® 27279 and asked respondents to indicate whether CPT® 27279 was greater, equal, or less in terms of work effort than the comparator code. A second survey was sent to 557 U.S.-based spine surgeon members of ISASS and 241 spine surgeon members of the Society for Minimally Invasive Spine Surgery ("SMISS"). The design of the second survey mirrored that of the first survey except for the use of a broader set of comparator CPT® codes (27 vs. 10). Using the work RVUs of the comparator codes, a Rasch analysis was performed to estimate the relative difficulty of CPT® 27279, after which the work RVU of CPT® 27279 was estimated by regression analysis.

Results: Twenty surgeons responded to the first survey and thirty-four surgeons responded to the second survey. The results of the regression analysis of the first survey indicate a work RVU for CPT® 27279 of 14.36 and the results of the regression analysis of the second survey indicate a work RVU for CPT® 27279 of 14.1.

Conclusion: The Rasch analysis indicates that the current work RVU assigned to CPT® 27279 is undervalued at 9.03. Averaging the results of the regression analyses of the two surveys indicates a work RVU for CPT® 27279 of 14.23.

Keywords: cpt code 27279; fusion; rasch; ruc; sacroiliac joint.

PubMed Disclaimer

Conflict of interest statement

This study was funded by the International Society for the Advancement of Spine Surgery (ISASS) and contributions by Globus, SI Bone, and Zyga. Melissa Martinson has a consulting arrangement with ISASS and is a paid consultant on this project.

Figures

Fig. 1
Fig. 1
Results of Regression Analysis to Estimate Work RVU of CPT® 27279
Fig. 2
Fig. 2
Results of Regression Analysis to Estimate RVUs of CPT® 27279.
See this image and copyright information in PMC

References

    1. Lorio MP. ISASS Proposed Recommendations/Coverage Criteria for Minimally Invasive Sacroiliac Joint Fusion 2016 – Coverage Indications, Limitations, and/or Medical Necessity. Updated July 2016.
    1. NASS Coverage Committee. Percutaneous Sacroiliac Joint Fusion. 2015. May,
    1. AMA/Specialty RVS Update Committee Meeting Minutes. 2015. Apr 24-27, https://download.ama-assn.org/resources/doc/rbrvs/april-2014-ruc-minutes....
    1. Florin RE. Rasch analysis in measurement of physician work. J Outcome Meas. 2000;4(2):564–78. - PubMed
    1. McCall NT, Cromwell J, Griggs ML. Five Year Review of Work Relative Value Units: Final Report. Section 2.2: The Identification of Potentially Misvalued Work RVUs, A Rasch Paired Comparison of Total Physician Work. Report by Health Economics Research, Inc. 1999. Jun 15, Downloaded 15 DEC2014 from http://www.rasch.org/florin.htm.

LinkOut - more resources