When Benchmarks Fail Us: A Case Study in Cytoreductive Surgery

doi:10.1245/s10434-024-16191-y

When Benchmarks Fail Us: A Case Study in Cytoreductive Surgery

,

Research output: Contribution to journal › Editorial

1 Scopus citations

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.

Original language	English
Pages (from-to)	19-23
Number of pages	5
Journal	Annals of Surgical Oncology
Volume	32
Issue number	1
DOIs	https://doi.org/10.1245/s10434-024-16191-y
State	Published - Jan 2025

Bibliographical note

Publisher Copyright:
© Society of Surgical Oncology 2024.

Funding

Varun V. Bansal was supported by a grant from the Irving Harris Foundation. David G. Su was supported by the NIH Immuno-Oncology Yale Cancer Center Advanced Training Program [T32 CA233414]. We thank the Society of Surgical Oncology (SSO) and the Advanced Cancer Therapies Organization Committees for lending our group a dedicated meeting space during their annual conferences.

Funders	Funder number
Irving Harris Foundation
Society of Surgical Oncology
Advanced Cancer Therapies Organization Committees
National Institutes of Health (NIH)	T32 CA233414
National Institutes of Health (NIH)

Keywords

Cytoreductive surgical procedures
Organization and administration
Peritoneal neoplasms
Peritoneal surface malignancies

ASJC Scopus subject areas

Surgery
Oncology

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10.1245/s10434-024-16191-y

Cite this

@article{a0e48e880e71433da0254fd0f4601d2f,

title = "When Benchmarks Fail Us: A Case Study in Cytoreductive Surgery",

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",

author = "Bansal, \{Varun V.\} and Witmer, \{Hunter D.D.\} and Childers, \{Christopher P.\} and Su, \{David G.\} and Turaga, \{Kiran K.\} and Yanghee Woo and Xavier Keutgen and William Morano and Bowne, \{Wilbur Bo\} and Vivian Strong and Vadim Gushchin and Umut Sarpel and Ugwuji Maduekwe and Travis Grotz and Trang Nguyen and Timothy Kennedy and Thinzar Lwin and TClark Gamblin and Steven Ahrendt and Stephanie Greco and Sherif Abdel-Misih and Seth Concors and Sepideh Gholami and Sean Dineen and Scott Sherman and Sanjay Bagaria and Samer Naffouje and Sameer Patel and Sam Pappas and Sabha Ganai and Ryan Merkow and Rupen Shah and Robert Sticca and Robert Barone and Richard Royal and Richard Hoehn and Richard Berri and Richard Alexander and Rebecca Wiatrek and Ravi Chokshi and Randall Zuckerman and Prakash Pandalai and Paul Mansfield and Sugarbaker, \{Paul H.\} and Patrick Wagner and Patricio Polanco and Oliver Eng and Niraj Gusani and Nikolaos Dallas and Mautin Barry-Hundeyin",

note = "Publisher Copyright: {\textcopyright} Society of Surgical Oncology 2024.",

year = "2025",

month = jan,

doi = "10.1245/s10434-024-16191-y",

language = "English",

volume = "32",

pages = "19--23",

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T1 - When Benchmarks Fail Us

T2 - A Case Study in Cytoreductive Surgery

AU - Bansal, Varun V.

AU - Witmer, Hunter D.D.

AU - Childers, Christopher P.

AU - Su, David G.

AU - Turaga, Kiran K.

AU - Woo, Yanghee

AU - Keutgen, Xavier

AU - Morano, William

AU - Bowne, Wilbur Bo

AU - Strong, Vivian

AU - Gushchin, Vadim

AU - Sarpel, Umut

AU - Maduekwe, Ugwuji

AU - Grotz, Travis

AU - Nguyen, Trang

AU - Kennedy, Timothy

AU - Lwin, Thinzar

AU - Gamblin, TClark

AU - Ahrendt, Steven

AU - Greco, Stephanie

AU - Abdel-Misih, Sherif

AU - Concors, Seth

AU - Gholami, Sepideh

AU - Dineen, Sean

AU - Sherman, Scott

AU - Bagaria, Sanjay

AU - Naffouje, Samer

AU - Patel, Sameer

AU - Pappas, Sam

AU - Ganai, Sabha

AU - Merkow, Ryan

AU - Shah, Rupen

AU - Sticca, Robert

AU - Barone, Robert

AU - Royal, Richard

AU - Hoehn, Richard

AU - Berri, Richard

AU - Alexander, Richard

AU - Wiatrek, Rebecca

AU - Chokshi, Ravi

AU - Zuckerman, Randall

AU - Pandalai, Prakash

AU - Mansfield, Paul

AU - Sugarbaker, Paul H.

AU - Wagner, Patrick

AU - Polanco, Patricio

AU - Eng, Oliver

AU - Gusani, Niraj

AU - Dallas, Nikolaos

AU - Barry-Hundeyin, Mautin

PY - 2025/1

Y1 - 2025/1

N2 - 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.

AB - 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.

KW - Cytoreductive surgical procedures

KW - Organization and administration

KW - Peritoneal neoplasms

KW - Peritoneal surface malignancies

UR - https://www.scopus.com/pages/publications/85207593066

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U2 - 10.1245/s10434-024-16191-y

DO - 10.1245/s10434-024-16191-y

M3 - Editorial

C2 - 39460818

AN - SCOPUS:85207593066

SN - 1068-9265

VL - 32

SP - 19

EP - 23

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

IS - 1

ER -

When Benchmarks Fail Us: A Case Study in Cytoreductive Surgery

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

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