CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 23420 RVU and Medicare Payment (2026)
Repair of shoulder — 13.2 work RVU, about $906.5 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 13.2
- PE RVU (non-facility)
- 11.17
- PE RVU (facility)
- 11.17
- MP RVU
- 2.77
- Office payment
- $906.5
- Facility payment
- $906.5
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 23420 in a non-facility setting with national GPCI: (13.2 + 11.17 + 2.77) × $33.4009 ≈ $906.5. The same code in a facility setting pays about $906.5 because facility PE RVU (11.17) replaces office PE RVU.
What changes by locality
GPCI moves 23420 non-facility payment from $809.02 to $1,109.66 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 23420?
13.2. 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 23420 in 2026?
About $906.5 non-facility ($906.5 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 (13.2) and malpractice RVU stay fixed; only practice expense changes (11.17 office vs 11.17 facility). That is the entire office-vs-facility payment gap.