The Impact of Virtual Surgical Planning on the Value of Orthognathic Surgery for the Maxillofacial Surgeon

Background: The practice of orthognathic surgery traditionally involved time-intensive presurgical planning that was associated with decreased compensation relative to other procedures within the specialty. This limited reimbursement and subsequent reduction in the incidence of these procedures has been described in the literature. The introduction of VSP has streamlined the presurgical planning process. The purpose of this study is to provide a reevaluation of the relative value units (RVUs) per unit time for orthognathic surgery and to make a comparison to other commonly performed plastic surgery procedures in the context of recent developments in VSP. Methods: RVU data for both orthognathic and common plastic surgery procedures were collected using Current Procedural Terminology (CPT) codes. A range of operative times was then used to calculate work RVUs per hour of both orthognathic surgery and other procedures commonly performed by plastic surgeons including: unilateral deep inferior epigastric perforator (DIEP) flap breast reconstruction, bilateral breast tissue expander placement, bilateral breast reduction, bilateral breast reconstruction using latissimus dorsi muscle flaps, and panniculectomy. Results: Hourly RVUs for orthognathic procedures compare favorably to hourly RVUs for other commonly performed plastic surgery procedures when examined within a range of expected average operative times. Conclusions: Accounting for the reduced time commitment to preoperative planning that VSP achieves, the authors demonstrate a significant RVU/hour increase in orthognathic procedures than that described in the literature published prior to the implementation of VSP. Orthognathic surgery remains competitive for maxillofacial surgeons when compared to other procedures in plastic surgery when RVUs/hour is the metric of comparison.