CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 63056 RVU and Medicare Payment (2026)
Decompress spinal cord lmbr — 21.31 work RVU, about $1,404.84 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 21.31
- PE RVU (non-facility)
- 13.59
- PE RVU (facility)
- 13.59
- MP RVU
- 7.16
- Office payment
- $1,404.84
- Facility payment
- $1,404.84
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 63056 in a non-facility setting with national GPCI: (21.31 + 13.59 + 7.16) × $33.4009 ≈ $1,404.84. The same code in a facility setting pays about $1,404.84 because facility PE RVU (13.59) replaces office PE RVU.
What changes by locality
GPCI moves 63056 non-facility payment from $1,220.29 to $1,789.11 across CMS localities — from Wisconsin 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 63056?
21.31. 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 63056 in 2026?
About $1,404.84 non-facility ($1,404.84 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 (21.31) and malpractice RVU stay fixed; only practice expense changes (13.59 office vs 13.59 facility). That is the entire office-vs-facility payment gap.