The same CPT is priced with different practice-expense RVUs depending on whether the physician service is billed in a nonfacility (office) versus facility setting. What financial impact should the coder recognize?
Select an answer to reveal the explanation.
Short Explanation
Same CPT, different “where”—and the practice-expense slice often changes. In the office, more of the overhead is baked into the physician payment, so nonfacility PE RVUs are usually higher than when the same service is done in a facility. Site of service is not just a label; it moves money.
Full Explanation
RBRVS distinguishes facility and nonfacility practice-expense RVUs for many codes to reflect where practice costs are incurred. In the nonfacility office setting, PE RVUs are typically higher because the physician payment includes more practice overhead; in a facility setting, some costs are paid through the facility and professional PE RVUs are often lower. Coders should recognize site-of-service payment differences as a financial impact of RBRVS, not assume PE values are identical across settings.