The codes listed below are exceptions where the facility practice expense reimbursement (FAC PE) is higher than the non-facility practice expense (NON-FAC PE). I consider these to be backwards because for all the other procedures (over 500) the Site of Service differential is higher for the office facility because there is a separate payment to the facility.
There are only four procedures, all orthopedic fracture care. I am not sure why they are backwards: perhaps the RVU’s were not adjusted; perhaps they will be changed to 10 day global (minor surgery). Perhaps the orthopedic society lobbied for the fees. They could be data errors. It is somewhat academic but is an exception to the phrase “Non-FAC PE’s are always higher than FAC PE.”
| CPT | Description | Global | NON FAC PE RVU | FAC PE RVU | RVU DIFF | RVU % DIFF | WORK RVU | MALPR | TOT NON FAC RVU | TOT FAC RVU |
| 26750 | Treat finger fracture each | 90 | 3.18 | 3.21 | -0.03 | -0.9% | 1.8 | 0.34 | 5.32 | ` |
| 27200 | Treat tail bone fracture | 90 | 3.03 | 3.11 | -0.08 | -2.6% | 1.92 | 0.37 | 5.32 | 5.4 |
| 23500 | Treat clavicle fracture | 90 | 3.68 | 3.81 | -0.13 | -3.4% | 2.21 | 0.43 | 6.32 | 6.45 |
| 23570 | Treat shoulder blade fx | 90 | 3.87 | 4.07 | -0.2 | -4.9% | 2.36 | 0.46 | 6.69 | 6.89 |
For the procedures above, the surgeon is paid more when performed in a facility (e.g. ASC) and less when performed in the office. There is negative incentive to perform these as office-based surgeries.