At our hospital at least they won't let you OJT. The NPs that work in the OR for the most part had significant OR experience prior to NP school. In addition transplant has a unique billing form that allows us to generate billing on inpatient surgical services.Īs far as training, thats implicit in PA school. However, I'll also say that since transplant has a low volume of surgery, we are definitely appreciated for our inpatient and outpatient management skills more than first assisting. But also procedure rich areas make up the rest of the top 10. There are four surgical areas in the top 10. For PAs Advance for PAs has stratified specialties by salary: There isn't good data for the NPs probably due to the dearth of NPs in surgery. I see jobs out there for it but no salary is listed, some say they will train while others prefer the RNFA certificate. So my next question is what does a starting and experienced typical salary look like for NP/PA first assist? Obviously areas like transplants and heart surgery reimburse at higher rates so I'm assuming those pay better than say ENT procedures? This is something that only an NPP can do. RN-First Assistant - CMC Surgery Services - Per Diem - 10 Hour - Days ESTIMATED: 62,659 per year John Muir Health. This allowed the physician to see more consults and schedule more surgeries. The final one third was increased physician productivity enabled by the PAs doing unbillable care (post of follow ups). One third was office procedures and visits. On the average they generated $302,000 for the practice (2002 dollars). It was done by a national consulting firm and looks at the revenue generate by PAs in orthopedics.
The AAPA has a very nice study that they use in their billing course. However this ignores the real value of of an NP or PA. So it might make sense to use them there. Other insurers make reimburse other first assistants such as CFAs and RNFAs. In a Medicare environment it absolutely makes no sense to use anyone but an NP, PA or CNS (where allowed). All of which frees up the surgeon to do other things. In addition they can round in the hospital, order and interpret labs and test as well as D/C the patient. So they will bring in around $2700 dollars to help support their salary as they do follow up care for the patient. On the other hand if a PA or NP first assists they will receive 13.6% of the surgeons fee (85% of 16%). If they use an RNFA they will receive no other reimbursement and the RNFA will not be able to participate in follow up care in a way that meets Medicare documentation requirements. If you do a Liver transplant (for example) with Medicare as the Payor,the surgeon will receive around $20k for the surgery and all of the follow up care for the next 90 days. The issue is that surgical reimbursement revolves for the most part around the operation. While a surgeon will hire an NP or a PA for what they do outside the OR, the ability to bill is key. Another big difference is what an FA who is also an advanced practice nurse can do outside of the OR, as trauma noted. That's an important difference, but I don't think it's "the one big" difference.
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