CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 28100 RVU and Medicare Payment (2026)
Removal of ankle/heel lesion — 5.68 work RVU, about $645.31 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.68
- PE RVU (non-facility)
- 12.75
- PE RVU (facility)
- 5.51
- MP RVU
- 0.89
- Office payment
- $645.31
- Facility payment
- $403.48
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 28100 in a non-facility setting with national GPCI: (5.68 + 12.75 + 0.89) × $33.4009 ≈ $645.31. The same code in a facility setting pays about $403.48 because facility PE RVU (5.51) replaces office PE RVU.
What changes by locality
GPCI moves 28100 non-facility payment from $570.84 to $840.61 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 28100?
5.68. 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 28100 in 2026?
About $645.31 non-facility ($403.48 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 (5.68) and malpractice RVU stay fixed; only practice expense changes (12.75 office vs 5.51 facility). That is the entire office-vs-facility payment gap.