CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 63085 RVU and Medicare Payment (2026)
Remove vert body dcmprn thrc — 28.73 work RVU, about $1,820.02 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 28.73
- PE RVU (non-facility)
- 16.13
- PE RVU (facility)
- 16.13
- MP RVU
- 9.63
- Office payment
- $1,820.02
- Facility payment
- $1,820.02
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 63085 in a non-facility setting with national GPCI: (28.73 + 16.13 + 9.63) × $33.4009 ≈ $1,820.02. The same code in a facility setting pays about $1,820.02 because facility PE RVU (16.13) replaces office PE RVU.
What changes by locality
GPCI moves 63085 non-facility payment from $1,574.81 to $2,333.91 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 63085?
28.73. 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 63085 in 2026?
About $1,820.02 non-facility ($1,820.02 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 (28.73) and malpractice RVU stay fixed; only practice expense changes (16.13 office vs 16.13 facility). That is the entire office-vs-facility payment gap.