Global Surgical Services: Post-Operative Visit and Valuation Summary Statistics (2024 Medicare fee-for-service claims)		
"April 29, 2026; RAND"		
		
"Overview: The ""Main results"" tab describes (1) the current valuation of certain global surgical services with 10 and 90-day global periods, including work relative value units (wRVUs) associated with post-operative visits assumed to occur during global periods for each code; (2) summary statistics on the number of post-operative visits that are reported to CMS using no-pay HCPCS code 99024; and (3) wRVUs remaining if all post-operative visits, post-operative visits in excess of the reported median count of visits, and post-operative visits in excess of the reported mean count of visits were removed from the total global surgical package valuation. The procedure codes included in the table are those for which 99024 reporting is required for certain practitioners in 9 states. Summary statistics on the count of reported post-operative visits and RVU calculations follow methods described in Crespin (2021) and earlier reports by RAND. The table contents uses calendar year 2024 valuation information and procedures. For counts of post-operative visits, the observation period for procedures at the end of calendar year 2024 extends into the first quarter of 2025. The variable descriptions below describe each column in the ""Main results"" tab including the relevant source and calculations, as applicable. "		
		
Variable	Source	Note
HCPCS 	CMS (2024)	Limited to codes for which HCPCS code 99024 reporting is required.
Short Description (HCPCS)	CMS (2024)	
Global Period	CMS (2024)	
(A) Addendum B total wRVUs	CY 2024 PFS Addendum B	
(B) CMS pre-service wRVUs	CY 2024 PFS Physician Time File (2024) and standard constant intensity	Time File times multiplied by 0.0081 RVUs/minute for pre-service scrub/dress/wait time and 0.0224 RVUs/minute for pre-service positioning and pre-service evaluation times
(C) CMS immed. post-service wRVUs	CY 2024 PFS Physician Time File (2024) and standard constant intensity	Time File immediate post-service time multiplied by 0.0224 RVUs/minute
(D) CMS post-op visit wRVUs	CY 2024 PFS Physician Time File (2024) and CY 2020 PFS valuations for separately billed E&M services	Time File counts of post-operative visits by relevant E&M level multiplied by CY 2020 PFS valuations for those E&M codes when separately billed
(E) CMS intra-service wRVUs	Calculated: A-B-C-D	Intra-service work is defined as the residual wRVUs remaining after other components are subtracted from total work
(F) Time File intra-service minutes	CY 2024 PFS Physician Time File (2024)	
(G) Intraservice work per unit time (IWPUT)	Calculated: E/F	
(H) Time File visits (n)	CY 2024 PFS Physician Time File (2024)	"This count includes ""half"" visits included in the Time File for discharge visits in some scenarios"
(I) Time File wRVUs/visit	Calculated: D/H	This average wRVU/visit amount is procedure-specific and reflects the mix of bundled post-operative visits
(J) Median 99024-observed post-op visits 	"Post-operative visits reported for 2024 ""clean"" procedures using HCPCS code 99024"	See Crespin et al. 2021 for details
(K) Mean 99024-observed post-op visits	"Post-operative visits reported for 2024 ""clean"" procedures using HCPCS code 99024"	See Crespin et al. 2021 for details
(L) Total wRVUs removing all post-op visits	Calculated: A-D	
"(M) IWPUT, removing all post-op visits"	Calculated: L/F	
"(N) Total wRVUs removing visits not observed, median"	Calculated: A-((H-J)*I)	
"(O) IWPUT, removing visits not observed, median"	Calculated: N/F	
"(P) Total wRVUs removing visits not observed, mean"	Calculated: A-((H-K)*I)	
"(Q) IWPUT, removing visits not observed, mean"	Calculated: P/F	
