CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21275 RVU and Medicare Payment (2026)
Revision orbitofacial bones — 11.47 work RVU, about $764.21 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 11.47
- PE RVU (non-facility)
- 9.28
- PE RVU (facility)
- 9.28
- MP RVU
- 2.13
- Office payment
- $764.21
- Facility payment
- $764.21
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 21275 in a non-facility setting with national GPCI: (11.47 + 9.28 + 2.13) × $33.4009 ≈ $764.21. The same code in a facility setting pays about $764.21 because facility PE RVU (9.28) replaces office PE RVU.
What changes by locality
GPCI moves 21275 non-facility payment from $686 to $943.97 across CMS localities — from Arkansas to Alaska. 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 21275?
11.47. 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 21275 in 2026?
About $764.21 non-facility ($764.21 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 (11.47) and malpractice RVU stay fixed; only practice expense changes (9.28 office vs 9.28 facility). That is the entire office-vs-facility payment gap.