CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 67255 RVU and Medicare Payment (2026)
Reinforce/graft eye wall — 8.17 work RVU, about $596.54 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 8.17
- PE RVU (non-facility)
- 9.04
- PE RVU (facility)
- 9.04
- MP RVU
- 0.65
- Office payment
- $596.54
- Facility payment
- $596.54
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 67255 in a non-facility setting with national GPCI: (8.17 + 9.04 + 0.65) × $33.4009 ≈ $596.54. The same code in a facility setting pays about $596.54 because facility PE RVU (9.04) replaces office PE RVU.
What changes by locality
GPCI moves 67255 non-facility payment from $543.44 to $749.94 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 67255?
8.17. 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 67255 in 2026?
About $596.54 non-facility ($596.54 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 (8.17) and malpractice RVU stay fixed; only practice expense changes (9.04 office vs 9.04 facility). That is the entire office-vs-facility payment gap.