CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 25265 RVU and Medicare Payment (2026)
Repair forearm tendon/muscle — 9.85 work RVU, about $688.06 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.85
- PE RVU (non-facility)
- 8.91
- PE RVU (facility)
- 8.91
- MP RVU
- 1.84
- Office payment
- $688.06
- Facility payment
- $688.06
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 25265 in a non-facility setting with national GPCI: (9.85 + 8.91 + 1.84) × $33.4009 ≈ $688.06. The same code in a facility setting pays about $688.06 because facility PE RVU (8.91) replaces office PE RVU.
What changes by locality
GPCI moves 25265 non-facility payment from $616.29 to $844.31 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 25265?
9.85. 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 25265 in 2026?
About $688.06 non-facility ($688.06 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 (9.85) and malpractice RVU stay fixed; only practice expense changes (8.91 office vs 8.91 facility). That is the entire office-vs-facility payment gap.