Below is a list of CPT codes from the Medicare PFSRVU database that have comparable total RVUs to CPT code 29848: Endoscopic Carpal Tunnel Surgery (ECTR). The Work RVU’s are also similar, most in 6-7 RVU range.
| CPT | Description | Global | NON FAC PE RVU | FAC PE RVU | WORK RVU | MALPR | TOT NON FAC RVU | TOT RVU | TOT FAC RVU |
| 59870 | Evacuate mole of uterus | 90 | 6.33 | 6.57 | 1.81 | 14.71 | |||
| 31030 | Exploration maxillary sinus | 90 | 11.81 | 8.05 | 6.01 | 0.64 | 18.46 | 18.46 | 14.7 |
| 26432 | Repair finger tendon | 90 | 9.8 | 4.16 | 0.74 | 14.7 | |||
| 42962 | Control throat bleeding | 90 | 6.31 | 7.4 | 0.99 | 14.7 | |||
| 66680 | Repair iris & ciliary body | 90 | 7.82 | 6.39 | 0.48 | 14.69 | |||
| 27393 | Lengthening of thigh tendon | 90 | 6.8 | 6.59 | 1.3 | 14.69 | |||
| 29848 | Wrist endoscopy/surgery | 90 | 7.14 | 6.39 | 1.16 | 14.69 | |||
| 24130 | Removal of head of radius | 90 | 7.06 | 6.42 | 1.21 | 14.69 | |||
| 50727 | Revise ureter | 90 | 5.37 | 8.28 | 1.04 | 14.69 | |||
| 29835 | Elbow arthroscopy/surgery | 90 | 6.74 | 6.62 | 1.31 | 14.67 | |||
| 21454 | Treat lower jaw fracture | 90 | 6.67 | 7.36 | 0.62 | 14.65 | |||
| 21360 | Opn tx dprsd malar fracture | 90 | 6.48 | 7.19 | 0.97 | 14.64 | |||
| 54530 | Removal of testis | 90 | 5.17 | 8.46 | 1 | 14.63 |
From the list above, six codes with similar total facility RVU’s are orthopedic codes. One code has an identical Work RVU and one code has an identical Total Facility RVU. All the others, like 29848, endoscopic carpal tunnel surgery, are considered “facility-only” procedures. Only one, 31030, has a Site of Service Differential of 3.76 RVUs or $135.70 based on a 2020 conversion rate of $36.09.
In other words, the physician is being paid $135.70 more for an office-based surgical suite (overhead) than if the same procedure was performed in an ASC. The reason most often offered for “facility-only” codes is anesthesia requirements and safety (risk). Based on the anesthesia requirements and risks to the patient, they are safer when performed in a facility rather than an office.