Impact of 2023 Ventral Hernia Repair CPT Code Changes on Work Relative Value Units in a Tertiary Hernia Referral Center.

Abstract

<h4>Background</h4>CPT codes for ventral hernia repair (VHR) changed in January 2023 to address the heterogeneity of procedures with a concomitant shift from a 90- to 0-day global period. This study reviews a tertiary referral center's experience with hernia coding comparing the work relative value units (wRVUs) generated for VHR pre-2023 compared with post-2023.<h4>Study design</h4>CPT codes were analyzed for patients undergoing open or laparoscopic VHR before updates to the CPT hernia codes (January 2022 to September 2022) and after CPT change (January 2023 to September 2023). wRVU values were assigned based on nationally published values. CPT codes in 2022, CPT codes in 2023, 8 inpatient evaluation and management (E&M) codes, and 5 outpatient E&M codes were evaluated.<h4>Results</h4>A total of 299 patients underwent VHR, 143 in 2022 and 156 in 2023. Average procedural VHR wRVUs increased from 9.6 in 2022 to 11.6 in 2023 (p < 0.001). Procedures involving myofascial advancement flaps or component separation techniques (53.8% vs 48.7%, p = 0.419) and wRVUs for the component separation procedures were similar between 2022 and 2023, respectively, 17.7 vs 16.1 (p = 0.419). The wRVUs associated with adjunctive procedures (mesh removal or placement) decreased from 3.3 to 0.6 (p < 0.001) in the post-2023 era. Postoperative E&M wRVUs increased in 2023 for postoperative inpatient (0.48) and postoperative outpatient (0.39) services, compared with 0 wRVUs in 2022. Overall, the total management including follow-up clinic visit adjusted wRVUs for hernia repair was similar between 2022 and 2023, respectively 30.7 vs 29.2 (p = 0.409).<h4>Conclusions</h4>Procedural wRVUs for anterior abdominal hernia repair increased from 2022 to 2023 (p < 0.001) at a tertiary referral medical center. However, total wRVUs, including the operation and postoperative visits, remained unchanged.