CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 67227 RVU and Medicare Payment (2026)
Dstrj extensive retinopathy — 3.41 work RVU, about $296.6 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.41
- PE RVU (non-facility)
- 5.21
- PE RVU (facility)
- 2.77
- MP RVU
- 0.26
- Office payment
- $296.6
- Facility payment
- $215.1
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 67227 in a non-facility setting with national GPCI: (3.41 + 5.21 + 0.26) × $33.4009 ≈ $296.6. The same code in a facility setting pays about $215.1 because facility PE RVU (2.77) replaces office PE RVU.
What changes by locality
GPCI moves 67227 non-facility payment from $267.85 to $382.02 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 67227?
3.41. 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 67227 in 2026?
About $296.6 non-facility ($215.1 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 (3.41) and malpractice RVU stay fixed; only practice expense changes (5.21 office vs 2.77 facility). That is the entire office-vs-facility payment gap.