Skip to main content
  • Cataract/Anterior Segment Pediatric/Strabismus Modifiers Glaucoma Coding Competency Retina Cornea Ask the Expert Oculofacial

    Fees for Office-Based Surgery


    Add to My Bookmarks
    One of my physicians would like to perform a blepharoplasty in the office instead of at the ambulatory surgery center (ASC). Our MAC has an allowable for an office site of service. Can we charge an in-house facility fee along with the surgical procedure?

    Answer: No, the site of service differential RVU for the office is higher to cover the practice expense which includes equipment and staff time. Anesthesia is also not separately billable for procedures performed in the office setting.
    In the office setting, Medicare beneficiaries cannot be billed a facility fee or supplies, even with an advanced beneficiary notice (ABN).

    Other payers may have varied policies regarding office-based surgery, but most would require language in your contract or a unique policy that states they will pay additional facility/supply costs in the office setting.

    Find additional education on RVUs in Fundamentals of Ophthalmic Coding.