CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 28406 RVU and Medicare Payment (2026)
Prq skel fix clcnl fx w/mnpj — 6.4 work RVU, about $549.44 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.4
- PE RVU (non-facility)
- 8.84
- PE RVU (facility)
- 8.84
- MP RVU
- 1.21
- Office payment
- $549.44
- Facility payment
- $549.44
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 28406 in a non-facility setting with national GPCI: (6.4 + 8.84 + 1.21) × $33.4009 ≈ $549.44. The same code in a facility setting pays about $549.44 because facility PE RVU (8.84) replaces office PE RVU.
What changes by locality
GPCI moves 28406 non-facility payment from $488.21 to $684.71 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 28406?
6.4. 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 28406 in 2026?
About $549.44 non-facility ($549.44 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 (6.4) and malpractice RVU stay fixed; only practice expense changes (8.84 office vs 8.84 facility). That is the entire office-vs-facility payment gap.