CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 67220 RVU and Medicare Payment (2026)
Treatment of choroid lesion — 6.2 work RVU, about $532.08 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.2
- PE RVU (non-facility)
- 9.25
- PE RVU (facility)
- 6.13
- MP RVU
- 0.48
- Office payment
- $532.08
- Facility payment
- $427.87
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 67220 in a non-facility setting with national GPCI: (6.2 + 9.25 + 0.48) × $33.4009 ≈ $532.08. The same code in a facility setting pays about $427.87 because facility PE RVU (6.13) replaces office PE RVU.
What changes by locality
GPCI moves 67220 non-facility payment from $480.74 to $683.98 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 67220?
6.2. 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 67220 in 2026?
About $532.08 non-facility ($427.87 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 (6.2) and malpractice RVU stay fixed; only practice expense changes (9.25 office vs 6.13 facility). That is the entire office-vs-facility payment gap.