CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31

CPT 76800 RVU and Medicare Payment (2026)

Us exam spinal canal — 1.1 work RVU, about $190.39 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
1.1
PE RVU (non-facility)
4.36
PE RVU (facility)
4.36
MP RVU
0.24
Office payment
$190.39
Facility payment
$190.39

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 76800 in a non-facility setting with national GPCI: (1.1 + 4.36 + 0.24) × $33.4009 ≈ $190.39. The same code in a facility setting pays about $190.39 because facility PE RVU (4.36) replaces office PE RVU.

What changes by locality

GPCI moves 76800 non-facility payment from $165.96 to $255.07 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 76800?

1.1. 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 76800 in 2026?

About $190.39 non-facility ($190.39 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 (1.1) and malpractice RVU stay fixed; only practice expense changes (4.36 office vs 4.36 facility). That is the entire office-vs-facility payment gap.