Rate Calculator

The ASGE GI Medicare reimbursement calculator is an interactive tool developed to help members calculate their national 2016 Medicare facility payments for GI endoscopy services. The calculator allows members to enter their annual volume per procedure to compare the difference between 2015 and 2016 national Medicare facility payment rates. The Calculator determines the national physician work reimbursement using the following formula: 

[relative work value (RVW) + practice expense (PE) + professional liability insurance (PLI)] x conversation fact.

Reminder - facility services are those which are performed in either the Hospital Outpatient or Ambulatory Surgical Center.

     
  Patient Volume  
  HSPCS Code You can find the list of GI endoscopy codes here  
    Enter procedure volume and one of the HSPCS codes to calculate the difference in your 2015 and 2016 physician wRVUs.  
  National Physician Fee Schedule Payment Rates    
  2015 Rate CF $35.7547  
  2016 Rate CF $35.8279  
         
  Percentage of Rate Change    
         
   
 
   
   

Putting the Pieces Together for GI Reimbursement

The stakes are high and ASGE understands the challenges that GI practices may face if the proposed reimbursement changes are finalized.  That’s why ASGE wants to be your partner in providing educational resources that will offset these potential cuts to GI reimbursement with other revenue- generating opportunities or efficiencies in practice management. 

Visit www.asge.org/home/practice-support for tools and resources that can immediately benefit your practice and help you put the pieces together for the changing GI reimbursement.

 

 

Disclaimer

Values in the ASGE GI Medicare reimbursement calculator is based on Medicare national reimbursement data in the Centers for Medicare and Medicaid Services’ (CMS) 2016 Medicare Physician Fee Schedule released on October 30, 2015. This data is subject to change without notice. The information in the Calculator is presenter for illustrative purposed only and does not constitute the total reimbursement for these services or legal advice.