CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 63086 RVU and Medicare Payment (2026)
Remove vertebral body add-on — 3.11 work RVU, about $171.01 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.11
- PE RVU (non-facility)
- 0.98
- PE RVU (facility)
- 0.98
- MP RVU
- 1.03
- Office payment
- $171.01
- Facility payment
- $171.01
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 63086 in a non-facility setting with national GPCI: (3.11 + 0.98 + 1.03) × $33.4009 ≈ $171.01. The same code in a facility setting pays about $171.01 because facility PE RVU (0.98) replaces office PE RVU.
What changes by locality
GPCI moves 63086 non-facility payment from $145.83 to $224.96 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 63086?
3.11. 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 63086 in 2026?
About $171.01 non-facility ($171.01 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 (3.11) and malpractice RVU stay fixed; only practice expense changes (0.98 office vs 0.98 facility). That is the entire office-vs-facility payment gap.