CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 25685 RVU and Medicare Payment (2026)
Optx trns-scphprlnr fx dislc — 9.84 work RVU, about $691.4 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.84
- PE RVU (non-facility)
- 8.77
- PE RVU (facility)
- 8.77
- MP RVU
- 2.09
- Office payment
- $691.4
- Facility payment
- $691.4
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 25685 in a non-facility setting with national GPCI: (9.84 + 8.77 + 2.09) × $33.4009 ≈ $691.4. The same code in a facility setting pays about $691.4 because facility PE RVU (8.77) replaces office PE RVU.
What changes by locality
GPCI moves 25685 non-facility payment from $616.24 to $843.43 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 25685?
9.84. 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 25685 in 2026?
About $691.4 non-facility ($691.4 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 (9.84) and malpractice RVU stay fixed; only practice expense changes (8.77 office vs 8.77 facility). That is the entire office-vs-facility payment gap.