CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 27428 RVU and Medicare Payment (2026)
Reconstruction knee — 15.19 work RVU, about $1,040.44 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 15.19
- PE RVU (non-facility)
- 12.73
- PE RVU (facility)
- 12.73
- MP RVU
- 3.23
- Office payment
- $1,040.44
- Facility payment
- $1,040.44
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 27428 in a non-facility setting with national GPCI: (15.19 + 12.73 + 3.23) × $33.4009 ≈ $1,040.44. The same code in a facility setting pays about $1,040.44 because facility PE RVU (12.73) replaces office PE RVU.
What changes by locality
GPCI moves 27428 non-facility payment from $928.16 to $1,273.32 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 27428?
15.19. 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 27428 in 2026?
About $1,040.44 non-facility ($1,040.44 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 (15.19) and malpractice RVU stay fixed; only practice expense changes (12.73 office vs 12.73 facility). That is the entire office-vs-facility payment gap.