CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 11012 RVU and Medicare Payment (2026)
Deb skin bone at fx site — 6.7 work RVU, about $686.72 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.7
- PE RVU (non-facility)
- 12.54
- PE RVU (facility)
- 2.83
- MP RVU
- 1.32
- Office payment
- $686.72
- Facility payment
- $362.4
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 11012 in a non-facility setting with national GPCI: (6.7 + 12.54 + 1.32) × $33.4009 ≈ $686.72. The same code in a facility setting pays about $362.4 because facility PE RVU (2.83) replaces office PE RVU.
What changes by locality
GPCI moves 11012 non-facility payment from $606.28 to $876.01 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 11012?
6.7. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 11012 in 2026?
About $686.72 non-facility ($362.4 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (6.7) and malpractice RVU stay fixed; only practice expense changes (12.54 office vs 2.83 facility). That is the entire office-vs-facility payment gap.