Current Procedural Terminology (CPT), the coding system for services pediatricians furnish, is closely linked to reimbursement through the resource-based relative value scale (RBRVS), which was developed by the Centers for Medicare and Medicaid Services (CMS) (formerly the Health Care Financing Administration [HCFA]) and adopted for Medicare physician payment in 1992. It has subsequently been regarded as the most generally accepted scale of relative physician reimbursement. The RBRVS takes into account the following 3 components: (1) the amount of physician work that goes into the service, (2) the practice expense associated with the service, and (3) the professional liability expense for the provision of the service. The RBRVS has been through 2 5-year review refinements with physician input. It is now used, in some form, by most payers, including most state Medicaid programs.The RBRVS has been widely regarded as a system that has established parity between cognitive specialties, such as general pediatricians, and surgical specialists, who, through the traditional indemnity insurance program, had become disproportionately reimbursed for their services. The reality, however, is that the RBRVS is still very much a procedure-oriented system. The resulting importance for pediatricians is to recognize this inherent inequity in the RBRVS system and capitalize on it by coding for procedures whenever possible (Table 1).A striking example of this disparity is the treatment of a subluxed radial head. The radial head subluxation reduction procedure (CPT code 24640) is straightforward, simple, fast, and very gratifying to the family as well as the pediatrician who diagnoses the subluxed radius and performs the reduction. Although taking minutes, it is reimbursed on the 2001 Medicare equivalent scale at approximately $153. Furthermore, it is readily reimbursed by providers as an “orthopedic procedure.” In addition, an evaluation and management (E/M) code can be billed using a -25 modifier if additional E/M services have been provided, such as evaluation of an associated head injury if the child had fallen and hit his or her head while subluxating the radius.It is important to remember that most surgical codes have global periods associated with treatment. This is referred to as the “surgical global package.” This varies from 0, 10, 30, and 90 days, depending on the complexity of the procedure. The 0-day global surgical codes traditionally have a starred symbol next to them in the CPT manual. This indicates that these surgical procedures are not associated with pre-procedure and post-procedure evaluations. As noted previously, they can be billed with associated E/M services using a -25 modifier on the E/M service.So, capitalize on the procedures you do, and consider expanding your repertoire to include wart treatment, circumcision, simple fracture treatment, and straightforward laceration repair, including dermabond. A list of straightforward procedures that pediatricians might consider adding to their expertise appears in Table 1. These should always be billed using procedure codes with additional E/M services using the appropriate E/M code with a modifier -25.