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The Essential RBRVS Updateable — Binder



2019 The Essential RBRVS

he Essential RBRVS gives you all the codes valued by CMS, as well as relative values for many codes
not valued for Medicare. The RBRVS for the Medicare Physician Fee Schedule (MPFS) is used to set
physician fees by Medicare and many commercial payers. However, the RBRVS does not provide a
complete schedule. Codes not valued for Medicare are referred to as “gap” codes. The Essential RBRVS
provides Medicare values and “gap” values to enable you to develop a more complete fee schedule.

Key Features and Benefits

• Optum360 Edge—Gap values for complete fee schedule development. Relative values for many
codes not valued by CMS for the Medicare Physician Fee Schedule.
• Includes the same data relied on by over 70 percent of commercial payers. Negotiate stronger
managed care contracts.
• Medicare payment indicators included. Global days, multiple procedure reduction, assistant
surgery, pre-op, intra-op and post-op percentages, OPPS cap, and other indicators commonly used for
Medicare and commercial claims.
• Organized by CPT® and HCPCS codes. Consistently value services and procedures from different
code sets.
• Total values and components for each code—including work, malpractice, practice expense,
and total RVUs. Evaluate the cost and productivity associated with a service, providing a more