Office or operating room?

It is helpful to know whether you are compensated more for time spent in the operating room or in the office. There are several ways to approach this issue. First, you can direct your software to add up the total amounts you collected for surgical and office services over a given period and then simply compare the two figures. You might also calculate the average amount of time you spent in the two venues.

In previous installments of PRACTICE MANAGEMENT CLINIC, we reviewed payments per CPT code according to carrier. A computer program that combines financials for the entire practice (figure) yields the following information for a hypothetical practice during January:

* The allergy collection percentage was 64% ($9,505.51/$14,855.60) and write-offs were 26% ($3,824.59/$14,855.60).

* The surgery collection percentage was 23% ($22,364.52/$98,774.00) and write-offs were 67% ($66,011.43/$98,774.00).

All data must be interpreted carefully. The large difference between the allergy and surgery percentages could result from many variables, such as the difference between the amount billed and the amount expected. Nevertheless, it is provocative to consider--strictly from a financial perspective--whether it is more profitable to work in the office or in the operating room.

Steven F. Isenberg, MD

Dr. Isenberg is an otolaryngologist in private practice in Indianapolis: [e-mail]

Monthly Period and YTD Totals by Modality
Report Date: 5/5/2005 3:18:39 PM

Payments                       December                  January

                      Payments   Write-offs    Payments    Write-offs

<Blank>               $8,621.90   $10,579.07   $42,153.32   $44,385.63
Allergy injections    $1,366.09      $276.73    $9,505.51    $3,824.59
Office consults         $153.20      $177.55      $674.55    $1,344.52
Surgery               $3,896.52    $9,902.75   $22,364.52   $66,011.43

Total Payments

Period Total         $14,037.71   $20,936.10   $74,697.90  $115,566.17

Charges                        December                  January

                      Quantity    Base Fee     Quantity     Base Fee

<Blank>                  39       $12,910.00      660      $112,117.00
Allergy injections       28          $532.00      422       $14,855.60
Office consults                                    4         $3,803.00
Surgery                  21       $26,923.00      130       $98,774.00

Payments                       February                  March

                      Payments   Write-offs    Payments    Write-offs

<Blank>              $52,901.13   $59,573.90   $51,431.33   $46,421.22
Allergy injections   $11,085.59    $6,060.23   $11,803.15    $2,060.27
Office consults         $138.39      $216.03      $499.00      $308.32
Surgery              $23,148.50   $68,812.12   $38,538.58  $133,326.62

Total Payments

Period Total         $87,273.61  $134,662.28  $102,272.06  $182,116.43

Charges                        February                  March

                      Quantity    Base Fee     Quantity     Base Fee

<Blank>                 495       $93,406.00      710      $110,010.00
Allergy injections      360       $22,305.80      444       $14,312.20
Office consults                                    6         $2,130.00
Surgery                 135      $138,715.00      193      $130,743.00

Figure. This report provides information that serves as a basis for
identifying differences in compensation for office and surgical
services.