CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 65272 RVU and Medicare Payment (2026)
Repair of eye wound — 4.5 work RVU, about $526.4 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 4.5
- PE RVU (non-facility)
- 10.9
- PE RVU (facility)
- 4.11
- MP RVU
- 0.36
- Office payment
- $526.4
- Facility payment
- $299.61
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 65272 in a non-facility setting with national GPCI: (4.5 + 10.9 + 0.36) × $33.4009 ≈ $526.4. The same code in a facility setting pays about $299.61 because facility PE RVU (4.11) replaces office PE RVU.
What changes by locality
GPCI moves 65272 non-facility payment from $469.23 to $698.27 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 65272?
4.5. 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 65272 in 2026?
About $526.4 non-facility ($299.61 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 (4.5) and malpractice RVU stay fixed; only practice expense changes (10.9 office vs 4.11 facility). That is the entire office-vs-facility payment gap.