How to figure what you are worth

CMS pays ~20/unit for both CRNAs and MDAs.
1 unit = 15 minutes of your anesthesia time which starts ~10 min before the anesthesia start time and ends at the PACU
All cases have a number of "base units". These are basically a pre defined number of units which particular cases get assigned as a base pay. These are more for complex cases etc.

Now payor mix changes everything. While medicare might pay 20/unit other private insurers can pay upwards of 100/unit. So you can see how that makes a difference.

This is the example I use in my practice model, buisness of anesthesia presentation. Feel free to apply it to your situation:

Relative Value Guide is divided into body
sections:
E.g..
– Lower Abdomen
• 00832 Ventral and Incisional Hernias
– 6 base units + time
» Time = 1unit/Q15min (usually)
Note: No differentiation for type of anesthetic

Patient Case: 68 y.o. male with ventral hernia. -
smoker, HTN
Procedure takes 1 hour
Medicare coverage
Conversion Factor (CF) ~$20.00/unit

00832 Ventral Hernia
6 base units + 1hr (4units) = 10units
10units x $20.00/units = $200.00
(Medicare pays 80% = $160.00)
(Patient pays 20% = $40.00)

In the previous case a total of $200.00 were
generated for an hour case – Medicare!!
30min turn around time + 30min lunch
+ x2 15min breaks
Can do 5 anesthetics/day
5 x $200 = $1000 (generated)/day

IF ALL YOU DID WAS Medicare CASES YOUR AVERAGE TOTAL SALARY PACKAGE WOULD BE:

365 days a year. = 52 weeks
- 5 weeks vacation time = 25 days
- 1 week for misc. time
- work ~5 days a week including call X 46 weeks
= 5 X 1000/day = 5000 X 46 =

$230, 000 GENERATED INCOME JUST DOING CMS CASES.

If you were solo billing all this yourself you can then calculate your benefit costs and figure out your salary plus bennies:

So 230K then =
30% of this would cover bennies
161K + Excellent Bennies.

That is what what you as a CRNA doing ONLY CMS cases generates. Now, there are NO places in the country where people do 100% CMS cases. So now lets look at what an average practice would make:

Billing Private Insured

Ventral Hernia
00832 Ventral Hernia
6 base units + 1hr (4units) = 10units
______________________________________
East Coast - CF range $30.00-$95.00/unit
Median $55.00
______________________________________
10units x $55.00/unit = $550.00
For a 1hr case!!!

Fees Paid for Anesthesia Services: 2007 Survey Results
Karin Bierstein, J.D., M.P.H. Associate Director of Professional
Affairs

Consider 5 elective cases
4 medicare/1 privately insured
_____________________________
Payer Mix = 70% Medicare
20% Pvt. Insured
4 cases x $200/case = $800.00
1 case x $550/case = $550.00
Total = $1350.00/day

Averaging $1350/day x 5 days/week
$6750.00
(consider 6 weeks off a year)
52weeks/year – 6weeks = 46weeks
__________________________
$6750.00 x 46weeks =

$310,500/year

So, that is the BARE MINIMUM someone may be making off your work. BARE minimum.

I suggest ALL CRNAs and SRNA learn billing. There is no way to negotiate for salary or understand when they are trying to pull the wool over your eyes unless you know what you are worth.