CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 28525 RVU and Medicare Payment (2026)
Treat toe fracture — 5.48 work RVU, about $573.49 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.48
- PE RVU (non-facility)
- 11
- PE RVU (facility)
- 5.38
- MP RVU
- 0.69
- Office payment
- $573.49
- Facility payment
- $385.78
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 28525 in a non-facility setting with national GPCI: (5.48 + 11 + 0.69) × $33.4009 ≈ $573.49. The same code in a facility setting pays about $385.78 because facility PE RVU (5.38) replaces office PE RVU.
What changes by locality
GPCI moves 28525 non-facility payment from $510.51 to $745.33 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 28525?
5.48. 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 28525 in 2026?
About $573.49 non-facility ($385.78 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 (5.48) and malpractice RVU stay fixed; only practice expense changes (11 office vs 5.38 facility). That is the entire office-vs-facility payment gap.