Michal Ursiny, MD

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

Thanks to my amazing MGH Radiation Oncology family for the send off after my last full day on campus. @MGHCancerCenter

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. federalregister.gov/documents/2025… 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

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

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. espn.com/mens-college-b…

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. ptpaplayers.com/legal-actions-…

Legendary sports commentator. RIP Mike

@drjkaouk @CleClinicUro Agreed. Similar experience to yours.

Their Hospital stay 11 days and blood transfusion 15% for simple prostatectomy 😱 Our simple prostatectomies are done as outpatients with 3-5 hours hospital stay, no transfusions after 400 cases done! Obviously we are not talking about the same procedure here ! @CleClinicUro

foreriverurology.com/mens-health/pr… Our experts at Fore River Urology offer comprehensive prostate care, including cutting-edge options for prostate cancer screening and treatment.

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

@CanesDavid my.clevelandclinic.org/online-service…

Uncomfortable but honest question for my fellow doctors: How do you feel about patients requesting communication/interpretation of results through chart messaging? I'm talking about things that require more than a very brief analysis? My feeling is that when our analysis is in the context of a visit (virtual or in person), we get compensated for our time and expertise, just like other professions. As it should. Has anyone taken a hard line on this? Am I being too callous?

What a finale

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

Go vote - this one matters. Focus on policies, not people. Vote for freedom, entrepreneurship, meritocracy. Vote against serfdom, censorship, bureaucracy. Go vote.

@MedUnivSC @MUSCSurgery @DJCSurgEd Nice work @DJCSurgEd !

The @MUSCSurgery Residency Program recently celebrated the grand opening of its Surgical Simulation Center. Dr. @DJCSurgEd, Director of Surgical Simulation, led the development of this innovative center. Congratulations to the program on the creation of this training facility!

Hey! Coming to AUA? Let's talk. wellprept.com/aua24/ #AUA24 #WellPrept #FixClinicDay #HelpFutureYou #medtwitter #surgtwitter

Very interesting.

@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.

UroTwitter - how do you manage patients with discordant biopsy path and PSA. High risk by PSA but only <5% G6 on a core or two on 18+ core biopsies, no lesions on MRI, PSA didn’t come down with abx. Have a few that I wonder what the right answer is. Surveillance? Focal?

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

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

2.5 Stone in a caliceal diverticulum. What would be your option? RIRS, PNL, Mini PNL or Lap?

@BKVarda_MD @elonmusk Much less junk here actually.

Is everyone else’s twitter feed going down the tubes?? I get so much junk now, I give up, sigh and close the app. @elonmusk

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