CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 23100 RVU and Medicare Payment (2026)
Arthrotomy glenhumrl jt w/bx — 6.05 work RVU, about $491.33 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.05
- PE RVU (non-facility)
- 7.37
- PE RVU (facility)
- 7.37
- MP RVU
- 1.29
- Office payment
- $491.33
- Facility payment
- $491.33
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 23100 in a non-facility setting with national GPCI: (6.05 + 7.37 + 1.29) × $33.4009 ≈ $491.33. The same code in a facility setting pays about $491.33 because facility PE RVU (7.37) replaces office PE RVU.
What changes by locality
GPCI moves 23100 non-facility payment from $435.72 to $602.37 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 23100?
6.05. 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 23100 in 2026?
About $491.33 non-facility ($491.33 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 (6.05) and malpractice RVU stay fixed; only practice expense changes (7.37 office vs 7.37 facility). That is the entire office-vs-facility payment gap.