CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 28315 RVU and Medicare Payment (2026)
Removal of sesamoid bone — 4.88 work RVU, about $481.31 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 4.88
- PE RVU (non-facility)
- 8.99
- PE RVU (facility)
- 3.89
- MP RVU
- 0.54
- Office payment
- $481.31
- Facility payment
- $310.96
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 28315 in a non-facility setting with national GPCI: (4.88 + 8.99 + 0.54) × $33.4009 ≈ $481.31. The same code in a facility setting pays about $310.96 because facility PE RVU (3.89) replaces office PE RVU.
What changes by locality
GPCI moves 28315 non-facility payment from $430.22 to $623.59 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 28315?
4.88. 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 28315 in 2026?
About $481.31 non-facility ($310.96 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 (4.88) and malpractice RVU stay fixed; only practice expense changes (8.99 office vs 3.89 facility). That is the entire office-vs-facility payment gap.