CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 67225 RVU and Medicare Payment (2026)
Eye photodynamic ther add-on — 0.46 work RVU, about $29.06 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.46
- PE RVU (non-facility)
- 0.37
- PE RVU (facility)
- 0.16
- MP RVU
- 0.04
- Office payment
- $29.06
- Facility payment
- $22.04
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 67225 in a non-facility setting with national GPCI: (0.46 + 0.37 + 0.04) × $33.4009 ≈ $29.06. The same code in a facility setting pays about $22.04 because facility PE RVU (0.16) replaces office PE RVU.
What changes by locality
GPCI moves 67225 non-facility payment from $26.67 to $36.94 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 67225?
0.46. 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 67225 in 2026?
About $29.06 non-facility ($22.04 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 (0.46) and malpractice RVU stay fixed; only practice expense changes (0.37 office vs 0.16 facility). That is the entire office-vs-facility payment gap.