CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 28420 RVU and Medicare Payment (2026)
Optx calcaneal fx w/bone grf — 17.08 work RVU, about $1,208.78 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 17.08
- PE RVU (non-facility)
- 15.48
- PE RVU (facility)
- 15.48
- MP RVU
- 3.63
- Office payment
- $1,208.78
- Facility payment
- $1,208.78
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 28420 in a non-facility setting with national GPCI: (17.08 + 15.48 + 3.63) × $33.4009 ≈ $1,208.78. The same code in a facility setting pays about $1,208.78 because facility PE RVU (15.48) replaces office PE RVU.
What changes by locality
GPCI moves 28420 non-facility payment from $1,077.07 to $1,473.19 across CMS localities — from Arkansas to Alaska. 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 28420?
17.08. 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 28420 in 2026?
About $1,208.78 non-facility ($1,208.78 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 (17.08) and malpractice RVU stay fixed; only practice expense changes (15.48 office vs 15.48 facility). That is the entire office-vs-facility payment gap.