CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 22116 RVU and Medicare Payment (2026)
Remove extra spine segment — 2.26 work RVU, about $125.92 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.26
- PE RVU (non-facility)
- 0.75
- PE RVU (facility)
- 0.75
- MP RVU
- 0.76
- Office payment
- $125.92
- Facility payment
- $125.92
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 22116 in a non-facility setting with national GPCI: (2.26 + 0.75 + 0.76) × $33.4009 ≈ $125.92. The same code in a facility setting pays about $125.92 because facility PE RVU (0.75) replaces office PE RVU.
What changes by locality
GPCI moves 22116 non-facility payment from $107.3 to $165.76 across CMS localities — from Wisconsin to Miami. 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 22116?
2.26. 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 22116 in 2026?
About $125.92 non-facility ($125.92 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 (2.26) and malpractice RVU stay fixed; only practice expense changes (0.75 office vs 0.75 facility). That is the entire office-vs-facility payment gap.