Out of 3784 procedures with a 90-day global (major surgery) in the 2020 Medicare PFSRVU database, 3247 or 86% have no Site of Service Differential when performed in the office. All reimbursement is at the facility rate only. I would consider these “facility-only” procedures. The median Site of Service Differential is 65% of the total RVU’s. Below are surgical procedures in the median range.
| CPT | Description | Global | NON FAC PE RVU | FAC PE RVU | RVU DIFF | RVU % DIFF | WORK RVU | MALPR | TOT NON FAC RVU | TOT FAC RVU |
| 68330 | Revise eyelid lining | 90 | 11.24 | 6.79 | 4.45 | 65.5% | 5.78 | 0.44 | 17.46 | 13.01 |
| 41112 | Excision of tongue lesion | 90 | 6.42 | 3.88 | 2.54 | 65.5% | 2.83 | 0.32 | 9.57 | 7.03 |
| 42260 | Repair nose to lip fistula | 90 | 12.19 | 7.37 | 4.82 | 65.4% | 10.22 | 1.39 | 23.8 | 18.98 |
| 46270 | Remove anal fist subq | 90 | 9.19 | 5.56 | 3.63 | 65.3% | 4.92 | 0.95 | 15.06 | 11.43 |
| 15793 | Chemical peel nonfacial | 90 | 9.08 | 5.5 | 3.58 | 65.1% | 3.96 | 0.6 | 13.64 | 10.06 |
| 19300 | Removal of breast tissue | 90 | 9.34 | 5.66 | 3.68 | 65.0% | 5.31 | 1.18 | 15.83 | 12.15 |
| 28114 | Removal of metatarsal heads | 90 | 16.93 | 10.27 | 6.66 | 64.8% | 12 | 1.56 | 30.49 | 23.83 |
| 41113 | Excision of tongue lesion | 90 | 6.74 | 4.1 | 2.64 | 64.4% | 3.29 | 0.37 | 10.4 | 7.76 |
| 15782 | Dermabrasion other than face | 90 | 10.49 | 6.39 | 4.1 | 64.2% | 4.44 | 0.42 | 15.35 | 11.25 |
| 15630 | Delay flap eye/nos/ear/lip | 90 | 8.45 | 5.16 | 3.29 | 63.8% | 4.08 | 0.53 | 13.06 | 9.77 |
| 46040 | Incision of rectal abscess | 90 | 9.23 | 5.66 | 3.57 | 63.1% | 5.37 | 1.13 | 15.73 | 12.16 |
Only one code is an orthopedic procedure, 28114 with total RVU’s of 12.15. The range of RVU differential is 2.54 or $91.67 to 6.66 RVUs or $240.36. In other words without overhead costs specific to a given procedure one would expect the total reimbursement for an office-based surgical suite to roughly around $175. There are extremes at both ends but that would be a good starting point for analysis.