CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 23485 RVU and Medicare Payment (2026)
Revision of collar bone — 13.56 work RVU, about $871.43 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 13.56
- PE RVU (non-facility)
- 9.77
- PE RVU (facility)
- 9.77
- MP RVU
- 2.76
- Office payment
- $871.43
- Facility payment
- $871.43
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 23485 in a non-facility setting with national GPCI: (13.56 + 9.77 + 2.76) × $33.4009 ≈ $871.43. The same code in a facility setting pays about $871.43 because facility PE RVU (9.77) replaces office PE RVU.
What changes by locality
GPCI moves 23485 non-facility payment from $780.71 to $1,077.71 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 23485?
13.56. 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 23485 in 2026?
About $871.43 non-facility ($871.43 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 (13.56) and malpractice RVU stay fixed; only practice expense changes (9.77 office vs 9.77 facility). That is the entire office-vs-facility payment gap.