CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 28285 RVU and Medicare Payment (2026)
Repair of hammertoe — 5.48 work RVU, about $548.44 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.48
- PE RVU (non-facility)
- 10.32
- PE RVU (facility)
- 5
- MP RVU
- 0.62
- Office payment
- $548.44
- Facility payment
- $370.75
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 28285 in a non-facility setting with national GPCI: (5.48 + 10.32 + 0.62) × $33.4009 ≈ $548.44. The same code in a facility setting pays about $370.75 because facility PE RVU (5) replaces office PE RVU.
What changes by locality
GPCI moves 28285 non-facility payment from $489.8 to $711.32 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 28285?
5.48. 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 28285 in 2026?
About $548.44 non-facility ($370.75 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 (5.48) and malpractice RVU stay fixed; only practice expense changes (10.32 office vs 5 facility). That is the entire office-vs-facility payment gap.