CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 23412 RVU and Medicare Payment (2026)
Repair rotator cuff chronic — 11.63 work RVU, about $791.6 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 11.63
- PE RVU (non-facility)
- 9.66
- PE RVU (facility)
- 9.66
- MP RVU
- 2.41
- Office payment
- $791.6
- Facility payment
- $791.6
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 23412 in a non-facility setting with national GPCI: (11.63 + 9.66 + 2.41) × $33.4009 ≈ $791.6. The same code in a facility setting pays about $791.6 because facility PE RVU (9.66) replaces office PE RVU.
What changes by locality
GPCI moves 23412 non-facility payment from $707.07 to $970.66 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 23412?
11.63. 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 23412 in 2026?
About $791.6 non-facility ($791.6 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 (11.63) and malpractice RVU stay fixed; only practice expense changes (9.66 office vs 9.66 facility). That is the entire office-vs-facility payment gap.