CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 63704 RVU and Medicare Payment (2026)
Repair of spinal herniation — 21.87 work RVU, about $1,670.38 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 21.87
- PE RVU (non-facility)
- 18.91
- PE RVU (facility)
- 18.91
- MP RVU
- 9.23
- Office payment
- $1,670.38
- Facility payment
- $1,670.38
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 63704 in a non-facility setting with national GPCI: (21.87 + 18.91 + 9.23) × $33.4009 ≈ $1,670.38. The same code in a facility setting pays about $1,670.38 because facility PE RVU (18.91) replaces office PE RVU.
What changes by locality
GPCI moves 63704 non-facility payment from $1,429.99 to $2,167.65 across CMS localities — from Nebraska 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 63704?
21.87. 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 63704 in 2026?
About $1,670.38 non-facility ($1,670.38 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 (21.87) and malpractice RVU stay fixed; only practice expense changes (18.91 office vs 18.91 facility). That is the entire office-vs-facility payment gap.