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Editorial
. 2025 Jan;32(1):19-23.
doi: 10.1245/s10434-024-16191-y. Epub 2024 Oct 26.

When Benchmarks Fail Us: A Case Study in Cytoreductive Surgery

Varun V Bansal  1 , Hunter D D Witmer  2 , Christopher P Childers  3 , David G Su  1 , Kiran K Turaga  4 ; RVU Writing Group; PSM Consortium Group
Collaborators, Affiliations
Editorial

When Benchmarks Fail Us: A Case Study in Cytoreductive Surgery

Varun V Bansal et al. Ann Surg Oncol. 2025 Jan.

Abstract

Introduction: Relative Value Units (RVUs) are utilized to measure physician work effort and create national benchmarks. Physicians are often measured against national benchmarks to determine compensation. Using a case study in cytoreductive surgery, we explored variability in coding that can impact national benchmarks.

Methods: A survey was conducted amongst surgeons in the peritoneal surface malignancies consortium (PSM). Data was collected on clinical experience, clinical full time equivalent, wRVUS and institutional coding practice.

Results: Coding of the same procedure resulted in significantly varying RVUs (IQR 60-101) across institutions. Higher volume (> 50% practice) appeared to have better coding practices with higher wRVU/case (Median 102 vs 62, p = 0.04).

Conclusions: There is significant variability in the measurement of similar effort across institutions due to coding variability. Such variability creates flaws in measurement necessary for benchmarks.

Keywords: Cytoreductive surgical procedures; Organization and administration; Peritoneal neoplasms; Peritoneal surface malignancies.

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Conflict of interest statement

Declarations. Disclosure: Kiran Turaga has received speaking fees from Aspire Bariatrics and Consulting fees from Merck and Co. outside of the submitted work. Other authors have no relevant financial disclosures. Ethical approval and consent to participate: The Yale University Institutional Review Board deemed the study to be exempt from review (ID 2000035244). Consent for publication: Not applicable.

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