CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 63005 RVU and Medicare Payment (2026)
Remove spine lamina 1/2 lmbr — 16.02 work RVU, about $1,192.41 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 16.02
- PE RVU (non-facility)
- 13.56
- PE RVU (facility)
- 13.56
- MP RVU
- 6.12
- Office payment
- $1,192.41
- Facility payment
- $1,192.41
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 63005 in a non-facility setting with national GPCI: (16.02 + 13.56 + 6.12) × $33.4009 ≈ $1,192.41. The same code in a facility setting pays about $1,192.41 because facility PE RVU (13.56) replaces office PE RVU.
What changes by locality
GPCI moves 63005 non-facility payment from $1,029.41 to $1,523.53 across CMS localities — from Arkansas to Miami. 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 63005?
16.02. 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 63005 in 2026?
About $1,192.41 non-facility ($1,192.41 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 (16.02) and malpractice RVU stay fixed; only practice expense changes (13.56 office vs 13.56 facility). That is the entire office-vs-facility payment gap.