CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31

CPT 28130 RVU and Medicare Payment (2026)

Removal of ankle bone — 9.26 work RVU, about $598.88 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
9.26
PE RVU (non-facility)
7.28
PE RVU (facility)
7.28
MP RVU
1.39
Office payment
$598.88
Facility payment
$598.88

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 28130 in a non-facility setting with national GPCI: (9.26 + 7.28 + 1.39) × $33.4009 ≈ $598.88. The same code in a facility setting pays about $598.88 because facility PE RVU (7.28) replaces office PE RVU.

What changes by locality

GPCI moves 28130 non-facility payment from $542.08 to $748.48 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 28130?

9.26. 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 28130 in 2026?

About $598.88 non-facility ($598.88 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 (9.26) and malpractice RVU stay fixed; only practice expense changes (7.28 office vs 7.28 facility). That is the entire office-vs-facility payment gap.