CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 65280 RVU and Medicare Payment (2026)
Repair of eye wound — 8.87 work RVU, about $565.81 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 8.87
- PE RVU (non-facility)
- 7.37
- PE RVU (facility)
- 7.37
- MP RVU
- 0.7
- Office payment
- $565.81
- Facility payment
- $565.81
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 65280 in a non-facility setting with national GPCI: (8.87 + 7.37 + 0.7) × $33.4009 ≈ $565.81. The same code in a facility setting pays about $565.81 because facility PE RVU (7.37) replaces office PE RVU.
What changes by locality
GPCI moves 65280 non-facility payment from $519.76 to $719.45 across CMS localities — from Arkansas to Alaska. 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 65280?
8.87. 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 65280 in 2026?
About $565.81 non-facility ($565.81 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 (8.87) and malpractice RVU stay fixed; only practice expense changes (7.37 office vs 7.37 facility). That is the entire office-vs-facility payment gap.