CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 28430 RVU and Medicare Payment (2026)
Cltx talus fracture w/o mnpj — 2.16 work RVU, about $265.87 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.16
- PE RVU (non-facility)
- 5.43
- PE RVU (facility)
- 3.96
- MP RVU
- 0.37
- Office payment
- $265.87
- Facility payment
- $216.77
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 28430 in a non-facility setting with national GPCI: (2.16 + 5.43 + 0.37) × $33.4009 ≈ $265.87. The same code in a facility setting pays about $216.77 because facility PE RVU (3.96) replaces office PE RVU.
What changes by locality
GPCI moves 28430 non-facility payment from $234.3 to $348.24 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 28430?
2.16. 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 28430 in 2026?
About $265.87 non-facility ($216.77 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 (2.16) and malpractice RVU stay fixed; only practice expense changes (5.43 office vs 3.96 facility). That is the entire office-vs-facility payment gap.