{"id":70,"date":"2020-11-04T14:50:08","date_gmt":"2020-11-04T14:50:08","guid":{"rendered":"https:\/\/12uh.com\/ioectr\/?p=70"},"modified":"2020-11-04T14:50:08","modified_gmt":"2020-11-04T14:50:08","slug":"median-site-of-service-differential","status":"publish","type":"post","link":"https:\/\/12uh.com\/ioectr\/median-site-of-service-differential\/","title":{"rendered":"Median Site of Service Differential"},"content":{"rendered":"\n

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<\/strong> when performed in the office. All reimbursement is at the facility rate only. I would consider these \u201cfacility-only\u201d procedures. The median Site of Service Differential is 65% of the total RVU\u2019s. Below are surgical procedures in the median range.<\/strong><\/p>\n\n\n\n

CPT<\/strong><\/td>Description<\/strong><\/td>Global<\/strong><\/td>NON FAC PE RVU<\/strong><\/td>FAC PE RVU<\/strong><\/td>RVU DIFF<\/strong><\/td>RVU % DIFF<\/strong><\/td>WORK RVU<\/strong><\/td>MALPR<\/strong><\/td>TOT NON FAC RVU<\/strong><\/td>TOT FAC RVU<\/strong><\/td><\/tr>
68330<\/td>Revise eyelid lining<\/td>90<\/td>11.24<\/td>6.79<\/td>4.45<\/td>65.5%<\/strong><\/td>5.78<\/td>0.44<\/td>17.46<\/td>13.01<\/td><\/tr>
41112<\/td>Excision of tongue lesion<\/td>90<\/td>6.42<\/td>3.88<\/td>2.54<\/td>65.5%<\/strong><\/td>2.83<\/td>0.32<\/td>9.57<\/td>7.03<\/td><\/tr>
42260<\/td>Repair nose to lip fistula<\/td>90<\/td>12.19<\/td>7.37<\/td>4.82<\/td>65.4%<\/strong><\/td>10.22<\/td>1.39<\/td>23.8<\/td>18.98<\/td><\/tr>
46270<\/td>Remove anal fist subq<\/td>90<\/td>9.19<\/td>5.56<\/td>3.63<\/td>65.3%<\/strong><\/td>4.92<\/td>0.95<\/td>15.06<\/td>11.43<\/td><\/tr>
15793<\/td>Chemical peel nonfacial<\/td>90<\/td>9.08<\/td>5.5<\/td>3.58<\/td>65.1%<\/strong><\/td>3.96<\/td>0.6<\/td>13.64<\/td>10.06<\/td><\/tr>
19300<\/strong><\/td>Removal of breast tissue<\/strong><\/td>90<\/strong><\/td>9.34<\/strong><\/td>5.66<\/strong><\/td>3.68<\/strong><\/td>65.0%<\/strong><\/td>5.31<\/strong><\/td>1.18<\/strong><\/td>15.83<\/strong><\/td>12.15<\/strong><\/td><\/tr>
28114<\/td>Removal of metatarsal heads<\/td>90<\/td>16.93<\/td>10.27<\/td>6.66<\/td>64.8%<\/strong><\/td>12<\/td>1.56<\/td>30.49<\/td>23.83<\/td><\/tr>
41113<\/td>Excision of tongue lesion<\/td>90<\/td>6.74<\/td>4.1<\/td>2.64<\/td>64.4%<\/strong><\/td>3.29<\/td>0.37<\/td>10.4<\/td>7.76<\/td><\/tr>
15782<\/td>Dermabrasion other than face<\/td>90<\/td>10.49<\/td>6.39<\/td>4.1<\/td>64.2%<\/strong><\/td>4.44<\/td>0.42<\/td>15.35<\/td>11.25<\/td><\/tr>
15630<\/td>Delay flap eye\/nos\/ear\/lip<\/td>90<\/td>8.45<\/td>5.16<\/td>3.29<\/td>63.8%<\/strong><\/td>4.08<\/td>0.53<\/td>13.06<\/td>9.77<\/td><\/tr>
46040<\/td>Incision of rectal abscess<\/td>90<\/td>9.23<\/td>5.66<\/td>3.57<\/td>63.1%<\/strong><\/td>5.37<\/td>1.13<\/td>15.73<\/td>12.16<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Only one code is an orthopedic procedure, 28114 with total RVU\u2019s 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.<\/p>\n","protected":false},"excerpt":{"rendered":"

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 \u201cfacility-only\u201d procedures. The median Site of Service Differential… Continue reading → <\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[32,3],"tags":[28,54,51,62,56,48,44,17,53,55,45,52,58,21,57,19],"class_list":["post-70","post","type-post","status-publish","format-standard","hentry","category-office-based-surgery","category-reimbursement","tag-fac-pe-rvus-2","tag-geographic-practice-cost-indices-gpci","tag-malpractice-rvus","tag-median-site-of-service-differential","tag-medicare-conversion-factor","tag-non-facility-payment-rate","tag-non-facility-reimbursement-rate","tag-office-based-surgery-reimbursement","tag-physician-work-rvus","tag-practice-expense-rvus","tag-relative-value-units","tag-rvum","tag-rvup","tag-rvus","tag-rvuw","tag-site-of-service-differential"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/12uh.com\/ioectr\/wp-json\/wp\/v2\/posts\/70","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/12uh.com\/ioectr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/12uh.com\/ioectr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/12uh.com\/ioectr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/12uh.com\/ioectr\/wp-json\/wp\/v2\/comments?post=70"}],"version-history":[{"count":1,"href":"https:\/\/12uh.com\/ioectr\/wp-json\/wp\/v2\/posts\/70\/revisions"}],"predecessor-version":[{"id":71,"href":"https:\/\/12uh.com\/ioectr\/wp-json\/wp\/v2\/posts\/70\/revisions\/71"}],"wp:attachment":[{"href":"https:\/\/12uh.com\/ioectr\/wp-json\/wp\/v2\/media?parent=70"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/12uh.com\/ioectr\/wp-json\/wp\/v2\/categories?post=70"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/12uh.com\/ioectr\/wp-json\/wp\/v2\/tags?post=70"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}