{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T18:30:01Z","timestamp":1766428201982,"version":"3.40.5"},"reference-count":12,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,1,17]],"date-time":"2019-01-17T00:00:00Z","timestamp":1547683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The Relative Value Scale Update Committee, commonly known as the RUC, is responsible for defining the value of Current Procedural Terminology (CPT) codes. The RUC process uses survey responses reporting operative times to determine procedure reimbursement, but it is limited by low response rates, small sample sizes, and unclear generalizability of the results. By comparing actual reported intraoperative times to the times determined by the RUC process, in this study we sought to assess the performance of RUC methodology in endoscopic sinus surgery (ESS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The ESS CPT codes that were reassessed in 2016 using the RUC method were examined in this study. Intraoperative time data for these codes were retrospectively collected from 14 medical facilities, using time stamps in the electronic health record. These actual intraoperative times were compared with the 2016 RUC survey results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 143 RUC physician survey responses and 446 actual procedure times included in the final analysis. There was significant variability within the RUC survey responses (ie, unilateral anterior ethmoidectomy times varied from 5 to 90 minutes). There was also a significant difference between the RUC survey results and actual intraoperative times (<jats:italic>p<\/jats:italic> &lt; 0.001). For example, frontal sinus surgeries showed a particularly poor correlation between actual and RUC times.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The RUC process may not accurately estimate or value actual intraoperative times. Real\u2010world intraoperative times are readily accessible and may be an alternative to survey\u2010based methodology in the future.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22283","type":"journal-article","created":{"date-parts":[[2019,1,17]],"date-time":"2019-01-17T19:15:28Z","timestamp":1547752528000},"page":"479-485","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["An analysis of RUC methodology for determining the RVU valuation of sinus surgery"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7026-5819","authenticated-orcid":false,"given":"Kristine A.","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2012Head and Neck Surgery University of Manitoba  Winnipeg MB Canada"},{"name":"Division of Otolaryngology\u2012Head and Neck Surgery University of Utah  Salt Lake City UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gretchen","family":"Oakley","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2012Head and Neck Surgery University of Utah  Salt Lake City UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0560-5028","authenticated-orcid":false,"given":"Jeremiah A.","family":"Alt","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2012Head and Neck Surgery University of Utah  Salt Lake City UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard R.","family":"Orlandi","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2012Head and Neck Surgery University of Utah  Salt Lake City UT"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,17]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"American Medical Association RVS Update Committee (RUC).2018.https:\/\/www.ama-assn.org\/rvs-update-committee-ruc. Accessed August 23 2018."},{"volume-title":"RVS Update Process","year":"2018","author":"American Medical Association\/Specialty Society","key":"e_1_2_6_3_1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558706293635"},{"journal-title":"Retina Today","article-title":"What the RUC is going on","author":"Williams G","key":"e_1_2_6_5_1"},{"key":"e_1_2_6_6_1","unstructured":"American Medical Association.Understanding the RUC survey instrument.2012.http:\/\/www.entnet.org\/sites\/default\/files\/2012-ruc-survey-presentation.pdf. Accessed August 23 2018."},{"key":"e_1_2_6_7_1","unstructured":"American Society of Echocardiography.What is the RUC and RUC Survey?2018.http:\/\/asecho.org\/what-is-the-ruc-and-ruc-survey. Accessed August 23 2018."},{"volume-title":"Meeting Minutes","year":"2017","author":"AMA\/Specialty Society RVS Update Committee","key":"e_1_2_6_8_1"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/JMDH.S104807"},{"key":"e_1_2_6_10_1","first-page":"e225","article-title":"Why are response rates in clinician surveys declining","volume":"58","author":"Wiebe ER","year":"2012","journal-title":"Can Fam Physician"},{"key":"e_1_2_6_11_1","unstructured":"American Medical Association CPT (Current Procedural Terminology).2018.https:\/\/www.ama-assn.org\/practice-management\/cpt-current-procedural-terminology. Accessed August 23 2018."},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26238"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25314"}],"container-title":["International Forum of Allergy &amp; Rhinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Falr.22283","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.22283","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/alr.22283","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.22283","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T14:01:32Z","timestamp":1694354492000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/alr.22283"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,17]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1002\/alr.22283"],"URL":"https:\/\/doi.org\/10.1002\/alr.22283","archive":["Portico"],"relation":{},"ISSN":["2042-6976","2042-6984"],"issn-type":[{"type":"print","value":"2042-6976"},{"type":"electronic","value":"2042-6984"}],"subject":[],"published":{"date-parts":[[2019,1,17]]},"assertion":[{"value":"2018-09-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}