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CMS-1403-FC
Table 50 illustrates, for selected commonly provided
procedures, how the payment amounts are affected solely by
the requirement in section 133(b) of the MIPPA that BN for
the 5-Year Review of physician work be applied to the CF
instead of through a separate work adjustor. While section
133(b) of the MIPPA does not increase or decrease
expenditures in the aggregate for physician services, it
will have a differential effect on services depending on
the proportion of the PFS payment that is accounted for by
work, PE, and malpractice. Physician work accounts for—on
average across all PFS services—52.5 percent of total work
RVUs. As BN for the 5-Year Review is being moved from the
physician work RVUs only to the total payment, any service
that has a higher than average proportion of its total
payment accounted for by physician work will see its total
payment increase solely as a result of section 133(b) of
the MIPPA. Conversely, any service where physician work
accounts for a lower than average proportion of its total
payment, section 133(b) of the MIPPA will result in a
reduction in payment. Thus, section 133(b) of the MIPPA
results in a payment reduction of 5 percent to CPT code
78565, Heart Image, 3d, Multiple, for the global service
and 6 percent for the TC only. Physician work is
11 percent of the total RVU for the global and 0 percent of
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