CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21812 RVU and Medicare Payment (2026)
Treatment of rib fracture — 12.68 work RVU, about $655.33 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 12.68
- PE RVU (non-facility)
- 3.87
- PE RVU (facility)
- 3.87
- MP RVU
- 3.07
- Office payment
- $655.33
- Facility payment
- $655.33
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 21812 in a non-facility setting with national GPCI: (12.68 + 3.87 + 3.07) × $33.4009 ≈ $655.33. The same code in a facility setting pays about $655.33 because facility PE RVU (3.87) replaces office PE RVU.
What changes by locality
GPCI moves 21812 non-facility payment from $578.94 to $829.45 across CMS localities — from Wisconsin 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 21812?
12.68. 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 21812 in 2026?
About $655.33 non-facility ($655.33 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 (12.68) and malpractice RVU stay fixed; only practice expense changes (3.87 office vs 3.87 facility). That is the entire office-vs-facility payment gap.