RBRVS fee schedule formula
Instructions:
1. Given the information below, calculate the payment for performing a repair of a nail bed (CPT code 11760) in Birmingham, Alabama. Show your work to receive credit.
The RBRVS fee schedule formula:
[(RVUw x GPCIw) + (RVUpe x GPCIpe) + (RVUm x GPCIm)] x CF = Payment
RVUw = 1.63
RVUpe = 1.91
RVUm = 0.22
GPCIw = 1.00
GPCIpe = 0.850
GPCIm = 0.617
National CF = $35.8013
Oachs, K. O. & Watters, A. L. (2016). Health Information Management Concepts, Principles, and Practice, 5th ed. Chicago, IL: American Health Information Management Association.
2. Analyze and explain the differences between fee-for-service, episode-of-care, and RBRVS payment methodologies.
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