Source of Funding: None PD29-10 RELATIVE VALUE UNITS DO NOT ADEQUATELY ACCOUNT FOR COMPLEXITY OR OPERATIVE TIME IN BENIGN PROSTATIC HYPERPLASIA PROCEDURES Da David Jiang*, Kyle Gillis, Jason Hedges, Nicholas chakiryan, Portland, OR INTRODUCTION AND OBJECTIVE: Relative value units (RVU) are the measure of value used in United States Medicare reim- bursement, as well as private insurance. Medicare determines physi- cian work RVU for a particular procedure based on operative time, technical skill and effort, mental effort and judgement, and stress. In theory, work RVU should account for the operative time involved in a procedure, resulting in equivalent RVUs per unit time for both short and long procedures. The primary aim of this study was to assess whether procedures treating benign prostatic hyperplasia (BPH) are adequately compensated based on complexity and operative time in the RVU system. METHODS: The American College of Surgeons National Sur- gical Quality Improvement Program (ACS-NSQIP) database was uti- lized from 2015-2017. Single current procedural terminology (CPT) codes associated with BPH-treatments were included: Transurethral resection of prostate (TURP), photovaporization of prostate (PVP), holmium laser enucleation (HoLEP), simple prostatectomy, transurethral destruction of prostate with thermotherapy (TUNA). Using work RVUs and total operative time, not including anesthesia time, the primary variable of work RVU per hour was generated (RVU/hr). Linear regression analysis was used to assess the relative influence of operative time had on the RVU/hr variable. RESULTS: 27,986 cases were included in the final study pop- ulation. Median RVU was 15.3 (IQR 12.2-15.3), median operative time was 48 minutes (IQR 47-48), and median RVU/hr was 19.1 (IQR 15.5- 19.1). From the highest to the lowest RVU/hr: TUNA 29.5, TURP 19.1, PVP 15.5, retropubic simple prostatectomy 10.2, HoLEP 9.5, supra- pubic simple prostatectomy 7.6. These RVU/hr were statistically significantly different (p<0.001). Linear regression analysis revealed that each additional hour of operative time was expected to decrease RVU/hr by -9.7 (-0.161 per minute, 95% CI: -0.16 - -0.16, p < 0.001). CONCLUSIONS: HoLEP and simple prostatectomy are more challenging and definitive procedures for BPH. This analysis of contemporary large population national-level data suggests that the RVU system does not reimburse HoLEP or simple prostatectomy appropriately based on complexity nor operative time. Source of Funding: none PD29-11 PROSTATIC URETHRAL LIFT: DOES BODY MASS INDEX AFFECT OUTCOMES? Mohannad Awad*, Erin Hunt, Richard Hartnett, Andrew Mahoney, Burlington, VT INTRODUCTION AND OBJECTIVE: Studies have established the effectiveness of Prostatic Urethral Lift (PUL); however, factors associated with success or failure of this new modality has never been reported. We sought to determine factors that may impact PUL outcomes. METHODS: A retrospective review of prospectively maintained Benign Prostatic Hyperplasia (BPH) database for patients who under- went PUL at University of Vermont Medical Center between 2017-2019 e622 THE JOURNAL OF UROLOGY Ò Vol. 203, No. 4S, Supplement, Saturday, May 16, 2020 Copyright © 2020 American Urological Association Education and Research, Inc. Unauthorized reproduction of this article is prohibited.