CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 22842 RVU and Medicare Payment (2026)
Insert spine fixation device — 12.25 work RVU, about $680.04 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 12.25
- PE RVU (non-facility)
- 4.1
- PE RVU (facility)
- 4.1
- MP RVU
- 4.01
- Office payment
- $680.04
- Facility payment
- $680.04
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 22842 in a non-facility setting with national GPCI: (12.25 + 4.1 + 4.01) × $33.4009 ≈ $680.04. The same code in a facility setting pays about $680.04 because facility PE RVU (4.1) replaces office PE RVU.
What changes by locality
GPCI moves 22842 non-facility payment from $581.61 to $890.45 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 22842?
12.25. 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 22842 in 2026?
About $680.04 non-facility ($680.04 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 (12.25) and malpractice RVU stay fixed; only practice expense changes (4.1 office vs 4.1 facility). That is the entire office-vs-facility payment gap.