{"id":443,"date":"2021-01-26T04:21:14","date_gmt":"2021-01-26T04:21:14","guid":{"rendered":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/?p=443"},"modified":"2021-01-26T04:21:14","modified_gmt":"2021-01-26T04:21:14","slug":"selected-cpt-rvus-and-medicare-allowable-reimbursement","status":"publish","type":"post","link":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/selected-cpt-rvus-and-medicare-allowable-reimbursement\/","title":{"rendered":"Selected CPT RVU&#8217;s and Medicare Allowable Reimbursement"},"content":{"rendered":"\n<p>The following graph is to illustrate that single surgical procedures&#8211;even complex ones do not reimburse in the tens of thousands. Most complex procedures require multiple procedures and the most of the high hospital costs go to the facility&#8211;the hospital and not the surgeon.<\/p>\n\n\n\n<p>The takeaway here that reimbursement for liposuction for lipedema close to the actual charged fees is a huge win. On a strict RVU comparison basis few CPT codes pay more than $5,000. We are working with surgeons and patients to get the highest reimbursement. Just remember that actual reimbursement for liposuction for lipedema can be anywhere between $300, $1,200 and the full amount ($7K to $15K).<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>CPT<\/td><td>DESCRIPTION<\/td><td>TOTAL<\/td><td>Medicare<\/td><td>&nbsp;<\/td><\/tr><tr><td>&nbsp;<\/td><td>&nbsp;<\/td><td>FACILITY RVU&#8217;S<\/td><td>Allowable<\/td><td>&nbsp;<\/td><\/tr><tr><td>39503<\/td><td>Repair of diaphragm hernia<\/td><td>173.2<\/td><td>\u00a0$6,250.72<\/td><td>1<\/td><\/tr><tr><td>47135<\/td><td>Transplantation of liver<\/td><td>157.05<\/td><td>\u00a0$5,667.87<\/td><td>2<\/td><\/tr><tr><td>43116<\/td><td>Partial removal of esophagus<\/td><td>145.06<\/td><td>\u00a0$5,235.16<\/td><td>3<\/td><\/tr><tr><td>49605<\/td><td>Repair umbilical lesion<\/td><td>144.61<\/td><td>\u00a0$5,218.92<\/td><td>4<\/td><\/tr><tr><td>33935<\/td><td>Transplantation heart\/lung<\/td><td>143.67<\/td><td>\u00a0$5,184.99<\/td><td>5<\/td><\/tr><tr><td>32854<\/td><td>Lung transplant with bypass<\/td><td>141.2<\/td><td>\u00a0$5,095.85<\/td><td>6<\/td><\/tr><tr><td>33945<\/td><td>Transplantation of heart<\/td><td>141.12<\/td><td>\u00a0$5,092.96<\/td><td>7<\/td><\/tr><tr><td>61698<\/td><td>Brain aneurysm repr complx<\/td><td>138.04<\/td><td>\u00a0$4,981.81<\/td><td>8<\/td><\/tr><tr><td>47142<\/td><td>Partial removal donor liver<\/td><td>137.42<\/td><td>\u00a0$4,959.43<\/td><td>9<\/td><\/tr><tr><td>61686<\/td><td>Intracranial vessel surgery<\/td><td>134.17<\/td><td>\u00a0$4,842.14<\/td><td>10<\/td><\/tr><tr><td>32853<\/td><td>Lung transplant double<\/td><td>132.95<\/td><td>\u00a0$4,798.11<\/td><td>11<\/td><\/tr><tr><td>43123<\/td><td>Partial removal of esophagus<\/td><td>131.17<\/td><td>\u00a0$4,733.87<\/td><td>12<\/td><\/tr><tr><td>43108<\/td><td>Removal of esophagus<\/td><td>129.57<\/td><td>\u00a0$4,676.13<\/td><td>13<\/td><\/tr><tr><td>43113<\/td><td>Removal of esophagus<\/td><td>126.47<\/td><td>\u00a0$4,564.25<\/td><td>14<\/td><\/tr><tr><td>47141<\/td><td>Partial removal donor liver<\/td><td>124.55<\/td><td>\u00a0$4,494.96<\/td><td>15<\/td><\/tr><tr><td>61682<\/td><td>Intracranial vessel surgery<\/td><td>123.73<\/td><td>\u00a0$4,465.37<\/td><td>16<\/td><\/tr><tr><td>46748<\/td><td>Repair of cloacal anomaly<\/td><td>123.42<\/td><td>\u00a0$4,454.18<\/td><td>17<\/td><\/tr><tr><td>61697<\/td><td>Brain aneurysm repr complx<\/td><td>122.67<\/td><td>\u00a0$4,427.11<\/td><td>18<\/td><\/tr><tr><td>33916<\/td><td>Surgery of great vessel<\/td><td>122.44<\/td><td>\u00a0$4,418.81<\/td><td>19<\/td><\/tr><tr><td>61576<\/td><td>Skull base\/brainstem surgery<\/td><td>121.37<\/td><td>\u00a0$4,380.19<\/td><td>20<\/td><\/tr><tr><td>33305<\/td><td>Repair of heart wound<\/td><td>118.96<\/td><td>\u00a0$4,293.22<\/td><td>21<\/td><\/tr><tr><td>61702<\/td><td>Inner skull vessel surgery<\/td><td>117.1<\/td><td>\u00a0$4,226.09<\/td><td>22<\/td><\/tr><tr><td>20808<\/td><td>Replantation hand complete<\/td><td>114.52<\/td><td>\u00a0$4,132.98<\/td><td>23<\/td><\/tr><tr><td>46746<\/td><td>Repair of cloacal anomaly<\/td><td>113.71<\/td><td>\u00a0$4,103.75<\/td><td>24<\/td><\/tr><tr><td>43124<\/td><td>Removal of esophagus<\/td><td>110.54<\/td><td>\u00a0$3,989.34<\/td><td>25<\/td><\/tr><tr><td>26554<\/td><td>Double transfer toe-hand<\/td><td>110.28<\/td><td>\u00a0$3,979.96<\/td><td>26<\/td><\/tr><tr><td>43288<\/td><td>Esphg thrsc moblj<\/td><td>109.81<\/td><td>\u00a0$3,963.00<\/td><td>27<\/td><\/tr><tr><td>&nbsp;<\/td><td>I included the procedures below as being comparable; you will need to argue the procedure should be reimbursed higher.<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>15830<\/td><td>Exc skin abd<\/td><td>33.98<\/td><td>\u00a0$1,226.32<\/td><td>&nbsp;<\/td><\/tr><tr><td>15832<\/td><td>Excise excessive skin thigh<\/td><td>26.57<\/td><td>\u00a0$ 958.90<\/td><td>&nbsp;<\/td><\/tr><tr><td>15833<\/td><td>Excise excessive skin leg<\/td><td>25.23<\/td><td>\u00a0$ 910.54<\/td><td>&nbsp;<\/td><\/tr><tr><td>15834<\/td><td>Excise excessive skin hip<\/td><td>25.73<\/td><td>\u00a0$\u00a0\u00a0928.59<\/td><td>&nbsp;<\/td><\/tr><tr><td>15835<\/td><td>Excise excessive skin buttck<\/td><td>26.98<\/td><td>\u00a0$\u00a0\u00a0973.70<\/td><td>&nbsp;<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The following graph is to illustrate that single surgical procedures&#8211;even complex ones do not reimburse in the tens of thousands. Most complex procedures require multiple procedures and the most of the high hospital costs go to the facility&#8211;the hospital and not the surgeon. The takeaway here that reimbursement for liposuction&#8230; <a class=\"continue-reading-link\" href=\"https:\/\/12uh.com\/lipoforlipedemareimbursement\/selected-cpt-rvus-and-medicare-allowable-reimbursement\/\"> Continue reading <span class=\"meta-nav\">&rarr; <\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[228,115],"tags":[230,114,24,26],"class_list":["post-443","post","type-post","status-publish","format-standard","hentry","category-228","category-cpt-coding","tag-coverlipedema","tag-cpt-codes","tag-medical-insurance-companies","tag-reimbursement-policy"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/posts\/443","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/comments?post=443"}],"version-history":[{"count":1,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/posts\/443\/revisions"}],"predecessor-version":[{"id":444,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/posts\/443\/revisions\/444"}],"wp:attachment":[{"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/media?parent=443"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/categories?post=443"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/tags?post=443"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}