Surgical Procedures with Comparable Work RVU’s to ECTR (6.39)

CPT	Description	Global	NON FAC PE RVU	FAC PE RVU	WORK RVU	MALPR	TOT NON FAC RVU	TOT RVU	TOT FAC RVU
24130	Removal of head of radius	90		7.06	6.42	1.21			14.69
29834	Elbow arthroscopy/surgery	90		6.55	6.42	1.22			14.19
58805	Drainage of ovarian cyst(s)	90		4.68	6.42	1.01			12.11
27687	Revision of calf tendon	90		5.76	6.41	0.92			13.09
46258	Remove in/ex hem grp w/fistu	90		5.75	6.41	1.56			13.72
66680	Repair iris & ciliary body	90		7.82	6.39	0.48			14.69
29848	Wrist endoscopy/surgery	90		7.14	6.39	1.16			14.69
46707	Repair anorectal fist w/plug	90		6.46	6.39	1.56			14.41
46280	Remove anal fist complex	90		6.25	6.39	1.07			13.71
22903	Exc abd les sc 3 cm/>	90		4.86	6.39	1.47			12.72
20662	Application of pelvis brace	90		7.16	6.38	1.26			14.8
23935	Drain arm/elbow bone lesion	90		7.12	6.38	1.24			14.74

In this list six additional codes are orthopedic. Unfortunately, none of the codes above have a Site of Service Differential; they are all considered “facility-only”.

The Work RVU’s are the same regardless of where the surgery is performed: the office, ASC, hospital outpatient or hospital. Essentially it is the surgeon’s reimbursement related to the complexity, time, effort, risk and skill required for the procedure. Note how in this list the total Facility RVU’s are very similar–in the 7 RVU range. I expanded the search to include Work RVU’s of 6.37 to 6.36 and found these:

CPT	Description	Global	NON FAC PE RVU	FAC PE RVU	Site of Serv Diff.	WORK RVU	MALPR	TOT NON FAC RVU	TOT RVU	TOT FAC RVU
14000	Tis trnfr trunk 10 sq cm/<	90	10.49	6.9	3.59	6.37	1.03	17.89	17.89	14.3
46060	Incision of rectal abscess	90		6.39		6.37	1.15			13.91
67210	Treatment of retinal lesion	90	7.81	7.28	0.53	6.36	0.48	14.65	14.65	14.12
67220	Treatment of choroid lesion	90	8.25	7.28	0.97	6.36	0.48	15.09	15.09	14.12
64708	Revise arm/leg nerve	90		6.96		6.36	1.19			14.51
67912	Correction eyelid w/implant	90	18.71	6.8	11.91	6.36	0.62	25.69	25.69	13.78
64738	Incision of jaw nerve	90		6.06		6.36	0.58			13
67935	Repair eyelid wound	90	10.02	5.62	4.4	6.36	0.54	16.92	16.92	12.52

While five have a Site of Service Differential, unfortunately none of these are orthopedic procedures, most are eye procedures and the Site of Service Differential varies widely. It ranges from .53 to 11.91. The one Integumentary Section code, 14000 has a Site of Service Differential of 3.59 or $129.56. In this case the takeaway is that each specialty association worked up appropriate facility and non-facility RVU reimbursement.

Below I calculated the 2020 Site of Service Differential dollar amounts for the six codes above. The range is from $19.13 to $419.83.

CPT	Description	NON FAC PE RVU	FAC PE RVU	Site of Serv Diff.	WORK RVU	MALPR	TOT NON FAC RVU	TOT FAC RVU	Office-Based Reimbursement
67210	Treatment of retinal lesion	7.81	7.28	0.53	6.36	0.48	14.65	14.12	$ 19.13
67220	Treatment of choroid lesion	8.25	7.28	0.97	6.36	0.48	15.09	14.12	$ 35.01
14000	Tis trnfr trunk 10 sq cm/<	10.49	6.9	3.59	6.37	1.03	17.89	14.3	$ 129.56
67935	Repair eyelid wound	10.02	5.62	4.4	6.36	0.54	16.92	12.52	$ 158.80
67912	Correction eyelid w/implant	18.71	6.8	11.91	6.36	0.62	25.69	13.78	$ 429.83