Surgeries can be performed in different Places of Service (POS)
Office: POS=11
Ambulatory Surgery Center: POS=22
Hospital Outpatient: POS=24
Hospital Inpatient: POS=21
Many minor surgeries such as biopsies, lesion removals and simple sutures are 10-day global procedures and routinely performed in the office. Typically a facility is used when the need for anesthesia beyond local or safety issues warrant it.
In this context our concern is for 90-day surgical procedures (technically considered “major surgery”) that are now routine, quick, and safe when performed in the office, often under only local anesthesia. WALANT procedures fall under this category. This is a relatively new trend and many of the procedures are still considered “facility-only.”
In addition, our interest is in particular those procedures that only have a facility payment rate and not a non-facility payment rate in the Medicare Physician Fee Schedule (PFSRVU database). That includes endoscopic carpal tunnel release as well as numerous common orthopedic, foot and eye procedures.