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Medical Care Research and Review, Vol. 63, No. 6, 764-777 (2006)
DOI: 10.1177/1077558706293635

Validation of Physician Survey Estimates of Surgical Time Using Operating Room Logs

Nancy McCall

RTI International

Jerry Cromwell

RTI International

Peter Braun

RTI International

The Medicare Physician Fee Schedule (MFS) is based on relative value units that represent the costliness of a particular service compared to all other services. Comparison of current surgical time estimates show systematically longer times than those obtained in the original Harvard study more than a decade ago. Any bias in surgical time estimates is likely to distort MFS payments across specialties. This study is the first to use objectively collected intraservice surgical time to validate estimates of time collected from small-group physician surveys. Median intraservice time estimates are significantly longer than intraservice times from operative logs. The average difference across 60 procedures is 31 minutes; the range is from a few minutes to almost 2 hours. Given that half of the studied surgical procedures is a subset of services that anchors the MFS, surgical times for other related services are likely to be overstated as well.

Key Words: physician payment • Medicare • RBRVS


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