Spine procedure wRVUs undervalued, study finds


A study published in a recent issue of the International Journal of Spine Surgery found the work relative value units assigned to open decompression and interlaminar stabilization are undervalued.

The International Society for the Advancement of Spine Surgery conducted an independent survey in 2018, asking spine surgeons to compare open decompression and laminar stabilization to 10 other comparable procedures. Twenty-eight surgeons participated in the survey.

Fifty-seven percent of the respondents said open decompression and laminar stabilization was most similar to decompression codes, and nearly 43 percent said the procedure was most similar to fusion codes. The respondents most often selected laminectomy as a reference procedure for similar work time and intensity to open decompression and laminar stabilization.

Open decompression and interlaminar stabilization has a category 1 current procedural terminology code, 22867, which has 13.5 work relative value units. The most comparable procedure, laminectomy, has 15.37 work relative value units, translating to higher pay.

"The survey results indicate that the wRVUs assigned to CPT 22867 are significantly undervalued at 13.5 and have directly resulted in the underreimbursement for surgeons performing the [interlaminar stabilization] procedure," concluded the study authors. "This misvaluation of the code has created a supply-and-demand anomaly in which the rate of [interlaminar stabilization] procedures has flatlined despite increasing rates of fusion procedures and an increasing older population."

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