CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21127 RVU and Medicare Payment (2026)
Augmentation mndblr b1 grf — 12.13 work RVU, about $3,968.03 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 12.13
- PE RVU (non-facility)
- 105.28
- PE RVU (facility)
- 7.31
- MP RVU
- 1.39
- Office payment
- $3,968.03
- Facility payment
- $695.74
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 21127 in a non-facility setting with national GPCI: (12.13 + 105.28 + 1.39) × $33.4009 ≈ $3,968.03. The same code in a facility setting pays about $695.74 because facility PE RVU (7.31) replaces office PE RVU.
What changes by locality
GPCI moves 21127 non-facility payment from $3,449.69 to $5,545.32 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 21127?
12.13. 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 21127 in 2026?
About $3,968.03 non-facility ($695.74 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 (12.13) and malpractice RVU stay fixed; only practice expense changes (105.28 office vs 7.31 facility). That is the entire office-vs-facility payment gap.