CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 27226 RVU and Medicare Payment (2026)
Treat hip wall fracture — 15.18 work RVU, about $967.29 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 15.18
- PE RVU (non-facility)
- 10.54
- PE RVU (facility)
- 10.54
- MP RVU
- 3.24
- Office payment
- $967.29
- Facility payment
- $967.29
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 27226 in a non-facility setting with national GPCI: (15.18 + 10.54 + 3.24) × $33.4009 ≈ $967.29. The same code in a facility setting pays about $967.29 because facility PE RVU (10.54) replaces office PE RVU.
What changes by locality
GPCI moves 27226 non-facility payment from $865.17 to $1,195.1 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 27226?
15.18. 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 27226 in 2026?
About $967.29 non-facility ($967.29 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 (15.18) and malpractice RVU stay fixed; only practice expense changes (10.54 office vs 10.54 facility). That is the entire office-vs-facility payment gap.