CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 22103 RVU and Medicare Payment (2026)
Remove extra spine segment — 2.28 work RVU, about $115.9 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.28
- PE RVU (non-facility)
- 0.69
- PE RVU (facility)
- 0.69
- MP RVU
- 0.5
- Office payment
- $115.9
- Facility payment
- $115.9
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 22103 in a non-facility setting with national GPCI: (2.28 + 0.69 + 0.5) × $33.4009 ≈ $115.9. The same code in a facility setting pays about $115.9 because facility PE RVU (0.69) replaces office PE RVU.
What changes by locality
GPCI moves 22103 non-facility payment from $103.38 to $147.98 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 22103?
2.28. 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 22103 in 2026?
About $115.9 non-facility ($115.9 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 (2.28) and malpractice RVU stay fixed; only practice expense changes (0.69 office vs 0.69 facility). That is the entire office-vs-facility payment gap.