Forum - Questions & Answers

May 10th, 2011 - JulietCenteno114

CPT® Charges for Hospital vs office

where can you refer me to find the cost/difference for a CPT® code that is done both in the hospital and office? I know there is a difference in cost. Thank you.

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May 12th, 2011 - Codapedia Editor 1,399 

re: CPT® Charges for Hospital vs office

Do you mean the difference in payment? The Medicare Physician Fee Schedule has two sets of values: facility and non-facility (or office.) The RVUs, which translate into payments, are lower for procedures done in the facility, when the procedure can be done in both locations.

Your Medicare Contractor should have a fee listing on their website, or you can search the CMS fee look up by CPT® code here:
https://www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx

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May 12th, 2011 - jschmutz   323 

re: CPT® Charges for Hospital vs office

You can get this from the physician fee schedule relative value file on the CMS website.

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