CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 68130 RVU and Medicare Payment (2026)
Exc les conjunctiva adj scl — 4.97 work RVU, about $554.45 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 4.97
- PE RVU (non-facility)
- 11.23
- PE RVU (facility)
- 5.34
- MP RVU
- 0.4
- Office payment
- $554.45
- Facility payment
- $357.72
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 68130 in a non-facility setting with national GPCI: (4.97 + 11.23 + 0.4) × $33.4009 ≈ $554.45. The same code in a facility setting pays about $357.72 because facility PE RVU (5.34) replaces office PE RVU.
What changes by locality
GPCI moves 68130 non-facility payment from $495.09 to $732.31 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 68130?
4.97. 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 68130 in 2026?
About $554.45 non-facility ($357.72 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 (4.97) and malpractice RVU stay fixed; only practice expense changes (11.23 office vs 5.34 facility). That is the entire office-vs-facility payment gap.