Provider Utilization & RVU Analysis Data

The Provider Utilization & RVU Analysis Data is a 12-month subscription, updated annually in July.  This data subscription represents a large and detailed analysis of Work-to-Total-RVU ratios for over 687,000 U.S. healthcare professionals, including medical physicians, podiatrists, nurse practitioners, physician assistants, dentists, and chiropractors.

HCTadvisor provides subscribers with detailed Work RVU, Practice Expense RVU, and Malpractice RVU analyses for 155 specialty groupings, with backup calculations available for individual professionals and HCPCS codes.  The 2016, 2017, and 2018 RVU analyses are performed using 2016 Medicare utilization data.  New 2017 utilization data will be available to subscribers in July 2019.

The specialty-based Work-RVU-to-Total-RVU ratio statistics may be referenced as a proxies for normalized compensation-to-collection rates for 155 unique types of healthcare specialists.  Compensation-to-collection rates are commonly used for:

  • Physician employee compensation-to-collection rates (read more)
  • Locum tenens compensation-to-collections rates (read more)
  • Global billing arrangement compensation-to-collection rates (read more)
    • Two ratio analysis scenarios are calculated using either (i) Professional (-26) or (ii) Global billing codes, when applicable, for all sub-specialties of Diagnostic Radiology, Interventional Cardiology, Interventional Radiology, Nuclear Medicine, Pathology, Radiation Oncology, and Vascular Surgery.

Summary tables are provided identifying overall specialty-level statistics, as well as 5th through 95th percentiles for Work-to-Total-RVU ratios using 2016, 2017, and 2018 Relative Value Units for national RVU values, as well as adjustments for all 112 Geographic Practice Cost Indices (GPCIs).

Stark-Designated Health Services (labs, imaging, therapies) are excluded from the analyses for the majority of specialties, with exceptions for specialties wherein Stark DHS are an integral component of physician services (i.e., Diagnostic Radiology, Interventional Cardiology, Interventional Radiology, Nuclear Medicine, Pathology, Radiation Oncology, and Vascular Surgery).

4 Major Findings – Video Demo:
https://youtu.be/Ts0WEkZ-EQ8?VQ=HD720

The national RVU backup calculations, comprising over 300 unique files with provider-level and HCPCS code-level details, are also available for instant download.  The GPCI-level calculation data is generally too large for most subscribers to use at about 10 gigabytes, but all 77 millions rows can be made available to subscribers upon written request.

Download Contents:

  • Summary Findings – Specialty Level – National RVU Weights
    • Overall Specialty Level Summaries (2016-2018) National RVU Component Weights (.csv format)
    • Work-to-Total RVU Percentiles (5th to 95th ) by Specialty (2016-2018) National RVU Component Weights (.csv format)
  • Summary Findings – Specialty Level – 112 Geographic Practice Cost Indices
    • Overall Specialty Level Summaries (2016-2018) 112 GPCIs (.csv format)
    • Work-to-Total RVU Percentiles (5th to 95th ) by Specialty (2016-2018) 112 GPCIs (.csv format)
  • Backup Data
    • NPI level calculation files for all specialties (National RVU Weights)
    • CPT level calculation files for all specialties (National RVU Weights)
    • Two ratio analysis scenarios are calculated using either (i) Professional (-26) or (ii) Global billing codes, when applicable, for all sub-specialties of Diagnostic Radiology, Interventional Cardiology, Interventional Radiology, Nuclear Medicine, Pathology, Radiation Oncology, and Vascular Surgery.
  • Supporting Documentation
    • 2016-2018 National Physician Fee Schedule Relative Value File October Release
    • 2016-2018 Geographic Practice Cost Indicies (GPCIs) by State and Medicare Locality
    • 2016-2018 Anesthesia Shares (work, practice expense, malpractice)
    • List HCPCS codes used to define Stark Designated Health Services

Important Disclaimers:

The summaries, calculations, and raw data provided are predicated on a large sample of Medicare utilization data that is updated annually.  HCTadvisor makes no representations as to whether this large sample is representative of the total utilization for any individual provider or any provider specialty as a whole.

Non-physician payment adjustments (typically 85% of physician payments) are not made in the summary analyses, because they represent payment adjustments and the data and analyses are focused on the underlying relative value units.

Anesthesiology calculation details are not included for the NPI or HCPCS level, because the work-to-total anesthesia shares are uniform for all anesthesia service units.  The Medicare-designated anesthesia work, practice expense, and malpractice shares for 2016-2018 are included in the supporting documentation.

Provider Utilization & RVU Analysis Data Sample Size (n=687,453):
wdt_ID Medicare 855i Primary Specialty NPI Self Identified Primary Specialty Sample (n)
1 Allergy/ Immunology Allergy & Immunology 1,968
2 Allergy/ Immunology Allergy & Immunology - Allergy 611
4 Cardiac Surgery Thoracic Surgery (Cardiothoracic Vascular Surgery) 1,091
5 Cardiovascular Disease (Cardiology) Internal Medicine - Cardiovascular Disease 15,565
6 Certified Clinical Nurse Specialist Clinical Nurse Specialist 340
7 Certified Clinical Nurse Specialist Clinical Nurse Specialist - Adult Health 315
8 Certified Clinical Nurse Specialist Clinical Nurse Specialist - Psychiatric/Mental Health 219
9 Certified Clinical Nurse Specialist Clinical Nurse Specialist - Psychiatric/Mental Health, Adult 276
10 Certified Nurse Midwife Advanced Practice Midwife 315
12 Chiropractic Chiropractor 32,273