Reimbursement for surgical procedures in gynecologic oncology.

Reimbursement for gynecologic oncologists can be categorized into three areas: payments for evaluation and management of clinical diagnosis, payments for chemotherapy, and reimbursement for surgical procedures. Revenue from surgical care is generally considered the major source of income for gynecologic oncologists. The transition to Medicare's resource-based relative value scale-based physician payment system began on January 1, 1992, culminating nearly a decade of effort by the medical profession and the government to change the way Medicare pays for physician services. The resource-based relative value scale payment schedule was fully phased in on January 1, 1996, and has been adopted by other third party payers. As a result of this reform, relative value units were created for current procedural technology codes and represent a composite of work, practice, and malpractice expenditures. When multiplied by a dollar conversion factor, relative value units can be used to calculate the reimbursement amount for all procedures covered by Medicare and other private insurers. Many of the discrepancies in reimbursement for similar procedures performed by gynecologists and urologists were partially corrected in 1997; however, sex-specific bias still exists in payment for surgical procedures performed on men and women.