CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 63172 RVU and Medicare Payment (2026)
Drainage of spinal cyst — 19.27 work RVU, about $1,398.83 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 19.27
- PE RVU (non-facility)
- 14.48
- PE RVU (facility)
- 14.48
- MP RVU
- 8.13
- Office payment
- $1,398.83
- Facility payment
- $1,398.83
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 63172 in a non-facility setting with national GPCI: (19.27 + 14.48 + 8.13) × $33.4009 ≈ $1,398.83. The same code in a facility setting pays about $1,398.83 because facility PE RVU (14.48) replaces office PE RVU.
What changes by locality
GPCI moves 63172 non-facility payment from $1,190.6 to $1,833.86 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 63172?
19.27. 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 63172 in 2026?
About $1,398.83 non-facility ($1,398.83 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 (19.27) and malpractice RVU stay fixed; only practice expense changes (14.48 office vs 14.48 facility). That is the entire office-vs-facility payment gap.