CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 28295 RVU and Medicare Payment (2026)
Cor hlx vlgs prx mtar osteot — 8.36 work RVU, about $1,065.15 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 8.36
- PE RVU (non-facility)
- 22.31
- PE RVU (facility)
- 7.27
- MP RVU
- 1.22
- Office payment
- $1,065.15
- Facility payment
- $562.81
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 28295 in a non-facility setting with national GPCI: (8.36 + 22.31 + 1.22) × $33.4009 ≈ $1,065.15. The same code in a facility setting pays about $562.81 because facility PE RVU (7.27) replaces office PE RVU.
What changes by locality
GPCI moves 28295 non-facility payment from $940.32 to $1,406.33 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 28295?
8.36. 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 28295 in 2026?
About $1,065.15 non-facility ($562.81 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 (8.36) and malpractice RVU stay fixed; only practice expense changes (22.31 office vs 7.27 facility). That is the entire office-vs-facility payment gap.