Michal Ursiny, MD

Urologist @FRUrology | @MGHUrology Alum

[Michal Ursiny, MD @UrsinyMD]

@TedHong9 @MGHCancerCenter @drjefstathiou @JenniferWo4 @HenningWillers @yockolate @sophia_kamran @KatieKeaneMD Congrats!!

[Justin Dubin, MD @justindubinmd]

TO ALL UROLOGISTS (sorry for long tweet but please give it a read)

The @CMSGov has once again changed some of the RVU values for surgeries and now while I do not perform as many BPH surgeries as I have in the past, I as well as the MAJORITY of practicing urologists, especially generalists are dedicated to the daily care of patients with benign prostatic hyperplasia (BPH). For decades, Transurethral Resection of the Prostate (TURP) has been the gold standard of surgical management for BPH, and it remains the benchmark in the rapidly evolving treatment landscape. The typical operative time for TURP has not changed and the procedure demands continuous mental focus, physical effort, and advanced technical skill.

The 2026 proposed rule recommends reducing the value of TURP (CPT 52601) to 10.00 wRVU—down from 13.16 in 2025. This constitutes a cut of nearly 25% in reimbursement and represents a serious miscalculation. The intensity and complexity of performing TURP have not diminished. The work required remains unchanged and should be recognized accordingly.

I have seen on several urology forums and chat groups how upset most urologists rightfully are about this, but little has been offered for fixing it. Here is an idea - not by me, but by my friend and excellent Urologist Dr. Michael Tradewell (@doctorT_urology) . His idea which I endorse, is below:

I urge CMS to maintain the 2025 TURP value of 13.16 wRVU and to re-scale the remaining 2026 Section II, E, 4(11) Transurethral Robotic-Assisted Resection of Prostate (CPT Codes 52500, 52601, 52630, 52648, 52649, and 52XX1) wRVU valuations using the proposed 2026 values relative to TURP.

For example, for aquablation (code 52xx1):
10.25 x 13.16 / 10.00 = 13.49

And for HoLEP (code 52649):
13.00 x 13.16 / 10.00  = 17.108

Adopting these values will provide fair and equitable compensation for the broad range of BPH treatments that urologists deliver now and in the years ahead.

Thank you for your consideration.
The proposed cuts to TURP are terrible…
I submitted a comment to the CMS 2026 Proposed Rule. It was easy.

You can do it too.

Go to this link and leave a comment. You can leave your own comment but if you agree with his recommended changes feel free to copy/paste that and/or share.

https://t.co/UOvXs85JTX

The 2026 CMS proposal was released around 14 days ago and today there are only 300 comments… Urologists have numbers, if we all submit to CMS we can hopefully move the needle in the right direction.

Instead of complaining to each other, we have the opportunity to work together and try to help our community by using our voices.

#SaveTURP

[Dutch Rojas @DutchRojas]

𝐌𝐞𝐝𝐢𝐜𝐚𝐫𝐞 𝐢𝐬 𝐩𝐚𝐲𝐢𝐧𝐠 𝐃𝐨𝐜𝐭𝐨𝐫𝐬 𝟏𝟗𝟗𝟖 𝐰𝐚𝐠𝐞𝐬 𝐭𝐨 𝐩𝐫𝐚𝐜𝐭𝐢𝐜𝐞 𝟐𝟎𝟐𝟓 𝐦𝐞𝐝𝐢𝐜𝐢𝐧𝐞.

𝐒𝐢𝐧𝐜𝐞 𝟏𝟗𝟗𝟖, 𝐢𝐧𝐟𝐥𝐚𝐭𝐢𝐨𝐧 𝐡𝐚𝐬 𝐫𝐢𝐬𝐞𝐧 𝟖𝟐.𝟏%.

Medicare’s physician payment formula (the Conversion Factor)?

Down 9.9%.

That’s not “fiscal responsibility.”
That’s institutional gaslighting.

𝐌𝐞𝐚𝐧𝐰𝐡𝐢𝐥𝐞, 𝐝𝐞𝐟𝐞𝐧𝐬𝐞 𝐜𝐨𝐧𝐭𝐫𝐚𝐜𝐭𝐬, 𝐂𝐄𝐎 𝐬𝐚𝐥𝐚𝐫𝐢𝐞𝐬, 𝐚𝐧𝐝 𝐢𝐧𝐬𝐢𝐝𝐞𝐫 𝐭𝐫𝐚𝐝𝐞𝐬 𝐟𝐥𝐨𝐮𝐫𝐢𝐬𝐡.

But the doctors treating Medicare patients?

They’re being asked to do more with less, year after year, because “𝐡𝐞𝐲, 𝐰𝐞 𝐝𝐨𝐧’𝐭 𝐡𝐚𝐯𝐞 𝐭𝐢𝐦𝐞 𝐭𝐨 𝐛𝐫𝐢𝐛𝐞 𝐂𝐨𝐧𝐠𝐫𝐞𝐬𝐬 𝐥𝐢𝐤𝐞 𝐞𝐯𝐞𝐫𝐲𝐨𝐧𝐞 𝐞𝐥𝐬𝐞”, while the cost of running a practice skyrockets.

If the American people want Congress to preserve access to care for aging Americans, it’s time to speak up and tie Medicare’s payment formula to inflation, just like their own salaries.

𝐔𝐧𝐭𝐢𝐥 𝐭𝐡𝐞𝐧, 𝐠𝐨𝐨𝐝 𝐥𝐮𝐜𝐤 𝐟𝐢𝐧𝐝𝐢𝐧𝐠 𝐚 𝐝𝐨𝐜𝐭𝐨𝐫 𝐰𝐡𝐨’𝐥𝐥 𝐭𝐚𝐤𝐞 𝐌𝐞𝐝𝐢𝐜𝐚𝐫𝐞.

They’re busy trying to survive the 20th century in the 21st.

#HealthcarePolicy #Medicare #PhysicianBurnout #InflationMath #FixTheFormula

[Fore River Urology @FRUrology]

March madness means “vas-madness” time again. If you reach out for a consult now, it’s inconceivable (😉) that we would take longer than a month to get you in.

https://t.co/LE2MNbd5A9

[Professional Tennis Players Association @ptpaplayers]

𝗜𝘁’𝘀 𝘁𝗶𝗺𝗲 𝘁𝗼 𝗳𝗶𝘅 𝘁𝗲𝗻𝗻𝗶𝘀.

Today, the PTPA and over a dozen players, on behalf of the entire professional population, filed a sweeping series of legal actions against the ATP, WTA, ITF and ITIA to reform professional tennis.

https://t.co/1r4LWQpopP

[Michal Ursiny, MD @UrsinyMD]

Legendary sports commentator. RIP Mike

[Pittsburgh Penguins @penguins]

Smiling like a butcher’s dog on us from above.

Thanks for everything you did for the Penguins and the city of Pittsburgh, Mikey.

[Michal Ursiny, MD @UrsinyMD]

@drjkaouk @CleClinicUro Agreed. Similar experience to yours.

[Fore River Urology @FRUrology]

https://t.co/1sn7MVCOqN

Our experts at Fore River Urology offer comprehensive prostate care, including cutting-edge options for prostate cancer screening and treatment.

[Michal Ursiny, MD @UrsinyMD]

@MjjCallegari @CanesDavid Low threshold to schedule/add-on for a quick telemed visit if requires MDM.

[Michal Ursiny, MD @UrsinyMD]

What a finale

[NCAA Soccer @NCAASoccer]

A golden moment for the Catamounts 🤩

#MCollegeCup x 🎥ESPN2 / @UVMmsoccer

[Michal Ursiny, MD @UrsinyMD]

Wow unbelievable, #UVM wins national title. Go Cats! #CollegeCupFinal

[Naval @naval]

Go vote - this one matters.

Focus on policies, not people.

Vote for freedom, entrepreneurship, meritocracy.

Vote against serfdom, censorship, bureaucracy.

Go vote.

[Michal Ursiny, MD @UrsinyMD]

@MedUnivSC @MUSCSurgery @DJCSurgEd Nice work @DJCSurgEd !

[WellPrept @WellPrept]

Hey! Coming to AUA? Let's talk.
https://t.co/F364Uj9cl1

#AUA24 #WellPrept #FixClinicDay #HelpFutureYou #medtwitter #surgtwitter

[Michal Ursiny, MD @UrsinyMD]

Very interesting.

[Badar M. Mian, MD @BadarMian1]

📣 ePub: ProBE-PC study of TR vs TP biopsy complications.
1st RCT ✅

💪 Tremendous job by the team @AlbanyMedUro @AlbanyMed

🙏 to the 763 patients who volunteered

Will discuss details, biases, blind spots @uroonc in 2 wks
@AmerUrological
#prostate

https://t.co/wbWkg3vUsP

[Michal Ursiny, MD @UrsinyMD]

@urogene I've had a few of these, a couple with completely negative biopsies too. Thus far I just have them on surveillance. These discordant high PSAs are puzzling.

[Matt Taibbi @mtaibbi]

Disgusting. Time to throw the bums out, all of them

[Michal Ursiny, MD @UrsinyMD]

@VicentiniUro What ended up being the approach and results of this case?

[Michal Ursiny, MD @UrsinyMD]

@BKVarda_MD @elonmusk Much less junk here actually.

[Michal Ursiny, MD @UrsinyMD]

What a game. Does this officially crown Saudi Arabia as the top team?