The RVU Shake-Up: Why CMS Is Cutting Surgical Pay—and What It Means for You

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 27 November 2025

⏱️ 40 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, we break down the upcoming CMS policy that will reduce work RVUs for nearly all non–time-based surgical CPT codes beginning January 1st. Dr. Chris Childers, surgical oncologist and health-policy expert, and Christian Shaughnessy, ACS Senior VP for Advocacy, join us to explain what these cuts mean for surgeons in both private practice and employed models. We explore why CMS believes surgeons are becoming “more efficient,” and why newly published data suggest the opposite may be true. Our guests outline the downstream financial, workforce, and patient-access implications of this unprecedented policy shift. Finally, we discuss how every surgeon can—and should—take action now to help prevent these cuts from taking effect.

Hosts:
Patrick Georgoff, MD, @georgoff
Christopher Childers, MD, PhD, @cchildersmd
Christian Shalgian, ACS Division of Advocacy and Health Policy Senior Vice President

Take action: https://www.facs.org/advocacy/regulatory-issues/fight-back-against-cuts-to-work-relative-value-units/

Longitudinal Trends in Efficiency and Complexity of Surgical Procedures: Analysis of 1.7 Million Operations Between 2019 and 2023: https://pubmed.ncbi.nlm.nih.gov/40801398/

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Transcript

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0:00.0	Behind the Knife.
0:24.9	This is Patrick Georgoff.
0:26.0	I want you to imagine this.
0:27.5	It's 2 a.m.
0:28.4	And you're rushing a hypotensive trauma patient to the operating room for exploration.
0:32.8	Maybe you need to go into the neck, the chest, or the abdomen.
0:36.1	Are you prepared for what you might find?
0:38.4	Trauma educational resources are extremely limited,
0:40.9	and that's why we created the trauma surgery video atlas.
0:44.1	24 challenging scenarios with high-yield text,
0:46.7	beautiful illustrations, and stunning professional grade video
0:49.7	that walks you through the approach and management of devastating injuries
0:53.1	in a step-by-step fashion.
0:55.2	Check out the link in the show notes.
0:56.5	For more, there are group discounts available as well.
0:59.5	Now, enjoy the episode and dominate the day.
1:03.9	The CMS efficiency adjustment for the first time has said,
1:07.4	you're getting more efficient.
1:08.7	We're not just going to drop your dollars.
1:10.4	We're going to drop your RVUs as well.
1:11.6	And so you do the exact same work, Patrick, this year, as you do next year.
1:16.6	You're going to get paid two and a half percent less if your account model doesn't change.
	...

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