CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 25405 RVU and Medicare Payment (2026)
Repair/graft radius or ulna — 14.63 work RVU, about $939.23 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 14.63
- PE RVU (non-facility)
- 10.62
- PE RVU (facility)
- 10.62
- MP RVU
- 2.87
- Office payment
- $939.23
- Facility payment
- $939.23
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 25405 in a non-facility setting with national GPCI: (14.63 + 10.62 + 2.87) × $33.4009 ≈ $939.23. The same code in a facility setting pays about $939.23 because facility PE RVU (10.62) replaces office PE RVU.
What changes by locality
GPCI moves 25405 non-facility payment from $842.73 to $1,163.58 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 25405?
14.63. 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 25405 in 2026?
About $939.23 non-facility ($939.23 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 (14.63) and malpractice RVU stay fixed; only practice expense changes (10.62 office vs 10.62 facility). That is the entire office-vs-facility payment gap.