Below is a list of the most common CPT codes (procedure codes) and there assigned relative value units (RVU) and work RVU used in a PM&R and interventional pain management clinic. These have all been updated for the 2014 changes from the Centers for Medicare and Medicaid Services (CMS). The data below is compiled from this CMS website.
Here is also a great collection of most CMS (Medicare) pain & spine physician payment rates for 2015 (compiled by ASIPP – American Society of Interventional Pain Physicians). Link
Here is a PDF version of the below table
|
2014 CPT and RVU numbers |
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|
CPT code |
Description |
Work RVU |
Total RVU |
|
99201 |
Office/outpatient visit new |
0.48 |
1.21 |
|
99202 |
Office/outpatient visit new |
0.93 |
2.08 |
|
99203 |
Office/outpatient visit new |
1.42 |
3.02 |
|
99204 |
Office/outpatient visit new |
2.43 |
4.64 |
|
99205 |
Office/outpatient visit new |
3.17 |
5.78 |
|
99211 |
Office/outpatient visit established |
0.18 |
0.56 |
|
99212 |
Office/outpatient visit established |
0.48 |
1.22 |
|
99213 |
Office/outpatient visit established |
0.97 |
2.04 |
|
99214 |
Office/outpatient visit established |
1.5 |
3.01 |
|
99215 |
Office/outpatient visit established |
2.11 |
4.03 |
|
99241 |
Office consultation |
0.64 |
1.37 |
|
99242 |
Office consultation |
1.34 |
2.57 |
|
99243 |
Office consultation |
1.88 |
3.51 |
|
99244 |
Office consultation |
3.02 |
5.19 |
|
99245 |
Office consultation |
3.77 |
6.35 |
|
Joints / Bursa / Muscle / Nerve / Other |
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|
20526 |
Carpal tunnel |
0.94 |
2.15 |
|
20550 |
Tendon sheath or ligament |
0.75 |
1.65 |
|
20551 |
Tendon origin/insertion |
0.75 |
1.71 |
|
20552 |
Trigger point, 1-2 muscles |
0.66 |
1.56 |
|
20553 |
Trigger point, 3+ muscles |
0.75 |
1.80 |
|
96372 |
Injection – intramuscular |
0.17 |
0.70 |
|
20600 |
Minor joint/bursa |
0.66 |
1.35 |
|
20605 |
Intermediate joint/bursa |
0.68 |
1.41 |
|
20610 |
Major joint/bursa |
0.79 |
1.70 |
|
27096 |
SIJ with fluoro |
1.48 |
4.61 |
|
20552 |
SIJ without fluoro |
0.66 |
1.56 |
|
64450 |
Other peripheral nerve |
0.75 |
2.26 |
|
64640 |
RFA – Sacral lateral branches |
1.23 |
3.78 |
|
64420 |
Intercostal nerve (single) |
1.18 |
3.20 |
|
64421 |
Intercostal nerve (multiple) |
1.68 |
4.34 |
|
64510 |
Stellate ganglion |
1.22 |
3.60 |
|
64520 |
Sympathetic T/L |
1.35 |
5.42 |
|
64530 |
Celiac plexus |
1.58 |
5.42 |
|
64405 |
Greater occipital block |
0.94 |
2.85 |
|
77002 |
Fluoroscopy – non-spinal |
0.54 |
2.88 |
|
77003 |
Fluoroscopy – spinal |
0.6 |
2.54 |
|
Spinal Cord Stimulator |
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|
63650 |
SCS trial |
7.15 |
37.67 |
|
63685 |
SCS pulse generator implant |
5.19 |
10.42 |
|
63661 |
SCS lead removal |
5.08 |
16.31 |
|
Botox Injections |
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|
95874 |
Needle EMG during chemodenervation |
0.37 |
2.02 |
|
64616 |
Chemodenervation for neck |
1.53 |
3.48 |
|
64615 |
Chemodenervation for face (migraines) |
1.85 |
4.07 |
|
64642 |
Chemodenervation 1 extremity 1-4 ms |
1.65 |
3.95 |
|
64643 |
each additional extremity, 1-4 ms |
1.22 |
2.60 |
|
64644 |
Chemodenervation, 1 extrem., 5+ ms |
1.82 |
4.51 |
|
64645 |
each additional extremity, 5+ ms |
1.39 |
3.18 |
|
Kyphoplasty |
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|
22523 |
Kypho (thoracic) 1st level |
9.04 |
209.01 |
|
22524 |
Kypho (lumbar) 1st level |
8.54 |
207.14 |
|
22525 |
Each additional level |
4.47 |
126.67 |
|
72291 |
Fluoroscopic guidance for kypho |
1.31 |
2.05 |
|
Vertebroplasty |
|||
|
22520 |
Vertebroplasty (thoracic) 1st level |
9.22 |
63.37 |
|
22521 |
Vertebroplasty (lumbar) 1st level |
8.65 |
63.45 |
|
22522 |
Vertebroplasty – each additional level |
4.30 |
6.48 |
|
72291 |
Fluoroscopic guidance for vertebro. |
1.31 |
2.05 |
|
Discograms |
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|
62291 |
Discogram – cervical/thoracic |
2.91 |
9.16 |
|
62290 |
Discogram – lumbar |
3 |
9.51 |
|
72285 |
Supervison fluoro for disco (C/T) |
1.16 |
3.26 |
|
72295 |
Supervison fluoro for disco (Lumbar) |
0.83 |
2.82 |
|
Epidurals |
|||
|
62310 |
IL ESI C/T |
1.18 |
3.09 |
|
62311 |
IL ESI L/S |
1.17 |
3.04 |
|
64479 |
TF ESI C/T first |
2.29 |
6.82 |
|
64480 |
TF ESI C/T each additional |
1.2 |
3.27 |
|
64483 |
TF ESI L/S first |
1.9 |
6.29 |
|
64484 |
TF ESI L/S each additional |
1 |
2.50 |
|
62273 |
Epidural blood patch |
2.15 |
4.93 |
|
Facet (Zygapophysial joint) |
|||
|
64490 |
Facet – C/T first |
1.82 |
5.48 |
|
64491 |
Facet – C/T second |
1.16 |
2.69 |
|
64492 |
Facet – C/T third & additional |
1.16 |
2.71 |
|
64493 |
Facet – L/S first |
1.52 |
4.95 |
|
64494 |
Facet – L/S second |
1 |
2.47 |
|
64495 |
Facet – L/S third & additional |
1 |
2.48 |
|
64633 |
RFA – C/T 1st joint |
3.84 |
12.30 |
|
64634 |
RFA – C/T each additional |
1.32 |
5.58 |
|
64635 |
RFA – L/S 1st joint |
3.78 |
12.13 |
|
64636 |
RFA – L/S each additional |
1.16 |
5.04 |
|
Electrodiagnostics (EMG/NCS) |
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|
95831 |
MMT (no hand) |
0.28 |
0.77 |
|
95832 |
MMT hands |
0.29 |
0.71 |
|
95860 |
1 extremity w or w/o paraspinal areas |
0.96 |
3.40 |
|
95861 |
2 extremities |
1.54 |
4.71 |
|
95863 |
3 extremities |
1.87 |
5.73 |
|
95864 |
4 extremities |
1.99 |
6.60 |
|
95867 |
Unilateral cranial nerve muscles |
0.79 |
2.62 |
|
95868 |
Bilateral cranial nerve muscles |
1.18 |
3.65 |
|
95869 |
Thoracic paraspinal muscles |
0.37 |
2.11 |
|
95874 |
Guidance with Botox |
0.37 |
2.02 |
|
95885 |
Limited 4 or fewer muscles |
0.35 |
1.64 |
|
95886 |
Complete 5+ muscles |
0.86 |
2.57 |
|
95907 |
1-2 studies |
1 |
2.66 |
|
95908 |
3-4 studies |
1.25 |
3.28 |
|
95909 |
5-6 studies |
1.5 |
3.95 |
|
95910 |
7-8 studies |
2 |
5.19 |
|
95911 |
9-10 studies |
2.5 |
6.31 |
|
95912 |
11-12 studies |
3 |
7.42 |
|
95913 |
13+ studies |
3.56 |
8.59 |
I will be on a wrvu model for my interventional pain practice as of March 1 of 2016. I perform all procedures in the hospital in an OR setting. When I perform a 2 level facet with the 50 modifier to indicate bilateral based on 2014 wrvu number would the wrvu be 2.52 times 2?
Thank you
That’s a good question, and I’m not sure the answer. Bilateral procedures are reimbursed at half the rate as the first site (for instance, a left L4/5 facet gets the full reimbursement, but the right L4/5 facet is half when done on the same day). I’m not sure how hospitals then calculate the wRVU numbers. Sorry Amish.