CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 67413 RVU and Medicare Payment (2026)
Explore/treat eye socket — 9.98 work RVU, about $847.05 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.98
- PE RVU (non-facility)
- 14.58
- PE RVU (facility)
- 14.58
- MP RVU
- 0.8
- Office payment
- $847.05
- Facility payment
- $847.05
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 67413 in a non-facility setting with national GPCI: (9.98 + 14.58 + 0.8) × $33.4009 ≈ $847.05. The same code in a facility setting pays about $847.05 because facility PE RVU (14.58) replaces office PE RVU.
What changes by locality
GPCI moves 67413 non-facility payment from $765.42 to $1,086.56 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 67413?
9.98. 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 67413 in 2026?
About $847.05 non-facility ($847.05 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 (9.98) and malpractice RVU stay fixed; only practice expense changes (14.58 office vs 14.58 facility). That is the entire office-vs-facility payment gap.