CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 22869 RVU and Medicare Payment (2026)
Insj stablj dev w/o dcmprn — 6.85 work RVU, about $395.13 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.85
- PE RVU (non-facility)
- 4.32
- PE RVU (facility)
- 4.32
- MP RVU
- 0.66
- Office payment
- $395.13
- Facility payment
- $395.13
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 22869 in a non-facility setting with national GPCI: (6.85 + 4.32 + 0.66) × $33.4009 ≈ $395.13. The same code in a facility setting pays about $395.13 because facility PE RVU (4.32) replaces office PE RVU.
What changes by locality
GPCI moves 22869 non-facility payment from $364.1 to $509.01 across CMS localities — from Arkansas 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 22869?
6.85. 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 22869 in 2026?
About $395.13 non-facility ($395.13 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 (6.85) and malpractice RVU stay fixed; only practice expense changes (4.32 office vs 4.32 facility). That is the entire office-vs-facility payment gap.