The list below are 90-day surgeries that have the lowest non-facility Practice Expense RVU’s or reimbursement in the 2020 PFSRVU Medicare database. While still considered “major surgery,” based on the NON-FAC PE these would be considered those that required the lowest overhead costs or risk. There is a likelihood that their Global fee will be changed to 10 days and they will be considered “in-office” procedures in the future.
| CPT | Description | Global | NON FAC PE RVU | FAC PE RVU | WORK RVU | MALPR | TOT NON FAC RVU | TOT FAC RVU |
| 28530 | Treat sesamoid bone fracture | 90 | 2.08 | 1.66 | 1.11 | 0.11 | 3.3 | 2.88 |
| 28510 | Treatment of toe fracture | 90 | 2.17 | 2.11 | 1.17 | 0.13 | 3.47 | 3.41 |
| 21820 | Treat sternum fracture | 90 | 2.55 | 2.52 | 1.36 | 0.27 | 4.18 | 4.15 |
| 28490 | Treat big toe fracture | 90 | 2.74 | 2.22 | 1.17 | 0.16 | 4.07 | 3.55 |
| 28515 | Treatment of toe fracture | 90 | 2.93 | 2.34 | 1.56 | 0.18 | 4.67 | 4.08 |
| 27200 | Treat tail bone fracture | 90 | 3.03 | 3.11 | 1.92 | 0.37 | 5.32 | 5.4 |
| 26750 | Treat finger fracture each | 90 | 3.18 | 3.21 | 1.8 | 0.34 | 5.32 | 5.35 |
| 28540 | Treat foot dislocation | 90 | 3.2 | 2.64 | 2.19 | 0.18 | 5.57 | 5.01 |
| 28495 | Treat big toe fracture | 90 | 3.23 | 2.38 | 1.68 | 0.19 | 5.1 | 4.25 |
| 28010 | Incision of toe tendon | 90 | 3.45 | 2.75 | 2.97 | 0.27 | 6.69 | 5.99 |
| 26720 | Treat finger fracture each | 90 | 3.58 | 3.24 | 1.76 | 0.32 | 5.66 | 5.32 |
Note also that the Site of Service differential is not that different with these codes, most are less than one RVU ($36.09) apart. All are orthopedic codes and most are fracture treatment codes. Two codes, 27200 and 26750 reimburse less in the office than the ASC. The Site of Service Differential for codes 26750 and 21820 is only .03 RVU’s or $1.08. It must be an oversight or data error as I cannot fathom any type of cost accounting for overhead determining that $1.08 is appropriate for an office-based surgery suite.