Abstract
Introduction
The Relative Value Unit (RVU) is one metric for assessing clinician productivity. A 2023 study revealed that compared to other surgical specialties, plastic surgery had the lowest RVU per hour and the highest operating time. Additionally, pediatric operations have been underrepresented in the annual reassessment of RVUs. The goal of our study was to investigate the relationship between RVU and operating time in pediatric surgical care.
Methods
The American College of Surgeons National Surgical Quality Improvement Program Pediatric (NSQIP-P) datasets from 2019 to 2023 were compiled. Cases were sorted by CPT code strings, and the top 10 most common CPT codes for each specialty were isolated. CPT codes with non-zero RVUs were included (N = 16,840). Pearson correlation coefficients were calculated for total RVUs versus total operating room time for each case.
Results
Results of the correlation analyses across seven surgical specialties are illustrated in Figure 1. On average, pediatric orthopedic surgery procedures had the greatest RVU per operative hour (R = 0.84), while pediatric surgery and plastic surgery had the lowest (R = 0.10 and 0.19, respectively). Orthopedic surgery’s average operative time was near the median (234 minutes), while plastic surgery was higher (290 minutes).
Conclusion
Plastic surgery procedures again demonstrated some of the lowest RVU-per-hour and highest operating-time values among the specialties studied, now replicated in a pediatric population. These findings suggest RVU valuations may not adequately capture the operative burden of pediatric plastic surgery, warranting reassessment of how productivity is measured in this field.