CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 28286 RVU and Medicare Payment (2026)
Repair of hammertoe — 4.58 work RVU, about $430.2 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 4.58
- PE RVU (non-facility)
- 7.9
- PE RVU (facility)
- 3.34
- MP RVU
- 0.4
- Office payment
- $430.2
- Facility payment
- $277.9
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 28286 in a non-facility setting with national GPCI: (4.58 + 7.9 + 0.4) × $33.4009 ≈ $430.2. The same code in a facility setting pays about $277.9 because facility PE RVU (3.34) replaces office PE RVU.
What changes by locality
GPCI moves 28286 non-facility payment from $386.52 to $557.46 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 28286?
4.58. 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 28286 in 2026?
About $430.2 non-facility ($277.9 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 (4.58) and malpractice RVU stay fixed; only practice expense changes (7.9 office vs 3.34 facility). That is the entire office-vs-facility payment gap.