CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 22804 RVU and Medicare Payment (2026)
Arthrd pst dfrm 13+ vrt sgm — 36.56 work RVU, about $2,222.5 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 36.56
- PE RVU (non-facility)
- 19.62
- PE RVU (facility)
- 19.62
- MP RVU
- 10.36
- Office payment
- $2,222.5
- Facility payment
- $2,222.5
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 22804 in a non-facility setting with national GPCI: (36.56 + 19.62 + 10.36) × $33.4009 ≈ $2,222.5. The same code in a facility setting pays about $2,222.5 because facility PE RVU (19.62) replaces office PE RVU.
What changes by locality
GPCI moves 22804 non-facility payment from $1,955.52 to $2,778.45 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 22804?
36.56. 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 22804 in 2026?
About $2,222.5 non-facility ($2,222.5 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 (36.56) and malpractice RVU stay fixed; only practice expense changes (19.62 office vs 19.62 facility). That is the entire office-vs-facility payment gap.