Variation in Operative Time and Work Relative Value Units in Gynecologic Surgery

The RVU (relative value unit) is designed to represent three components of care: physician work, practice expense, and malpractice costs. Physician work represents the amount of effort required for preoperative evaluation, intraoperative performance of surgery, and postoperative care. Operative time is used in this formulation. Surveys are administered to physicians asking them to reflect on the amount of time they spend performing specific procedures, which may be subject to recall bias.1,2 Since its inception, procedures for women have been undervalued by the RVU system.3-5 However, it is unknown whether gynecologic subspecialists spend different amounts of time in the operating room, operating on distinct patient populations, to generate the same RVUs. To study this, we compared patient population characteristics, operative time, and per-hour and per-procedure RVUs stratified by gynecologic subspecialty. © 2022 by the American College of Obstetricians and Gynecologists.