Trends in Reimbursement and RVUs for Interventional Radiology Procedures vs. Other Specialties

Monday, March 31, 2025

4:55 PM – 5:00 PM CT

Location: Music City Center, 205 A

Abstract Presenter(s)

Victoria Furlong-Servin, DO

Resident Physician
INTEGRIS Health, United States

Author/Co-author(s)

Donald B. Smith, DO

Resident Physician
Integris Baptist Medican Center Radiology Residency, United States
DT

Deshauna Tucker, DO

Resident Physician
Integris Health, United States
RT

Ryan Trojan, MD

Attending Physician
INTEGRIS, United States

Learning Objectives: Our purpose to explore how RVUs and reimbursement impact IR practitioners and to compare the trends across surgical, endoscopic, and other minimally invasive specialties.

Background: From 2011 to 2024, IR procedures experienced significant reductions in Medicare reimbursement and Relative Value Units (RVUs) compared to similar procedures performed by other specialties.

Clinical Findings/Procedure Details:

Disproportionate Decline in IR Reimbursement:

IR procedures: Reimbursement decreased by 6.9%.

Non-IR procedures: Reimbursement decreased by 2.5%.

Example: Endovenous ablation saw a 23.2% decline, compared to a 3.7% decline for non-IR ligation of varicose veins.

RVUs:

Work RVUs: Decreased in 78.3% of IR procedures, compared to 26.1% in non-IR.

Practice Expense RVUs: IR declined by 19.2%, compared to 16.5% for non-IR.

Malpractice RVUs: IR saw a 2.7% decrease, while non-IR increased by 3.9%.

Comparison Across Specialties:

IR: Procedures such as endovenous ablation, percutaneous radiofrequency ablation (RFA), and carotid stenting faced significant reductions.

Surgical Specialties: Generally saw modest changes, with some even increasing in reimbursement and RVUs.

Endoscopic Specialties: Endoscopic procedures experienced less impact than IR but still faced larger declines compared to surgical specialties.

Challenges Unique to IR:

Relativity Screens: IR procedures are more frequently flagged for reassessment, leading to larger cuts.

High Capital Expenditure: Expensive equipment and single-use devices contribute to reductions in practice expense RVUs.

Strategies for Mitigation:

Data Reporting: Publish data demonstrating the cost efficiency and patient benefits of IR procedures.

Value-based models: Explore different payment models for more stable reimbursements.

Advocacy: IR societies should engage with Medicare and the AMA for fair RVU assessments. IR physicians should also deepen their understanding of healthcare economics and policy to better advocate for the specialty.

Conclusion and/or Teaching Points: Interventional Radiology has faced greater declines in reimbursement and RVU valuations compared to other specialties. To protect reimbursement rates, IR practitioners must focus on advocacy, data collection, and policy engagement.