Work RVU values for the highest-volume orthopedic procedures, sorted by value, with the compensation math they feed. CY2026 CMS Physician Fee Schedule.
| CPT code | Procedure (plain language) | Work RVU | Global period |
|---|---|---|---|
| 22612 | Lumbar spinal fusion, posterolateral approach (single level) | 22.94 | 90 days |
| 23472 | Total shoulder replacement (anatomic or reverse) | 21.58 | 90 days |
| 27447 | Total knee replacement | 19.11 | 90 days |
| 27130 | Total hip replacement | 19.11 | 90 days |
| 27236 | Partial hip replacement / fixation for femoral neck fracture | 17.17 | 90 days |
| 29827 | Shoulder arthroscopy with rotator cuff repair | 15.20 | 90 days |
| 63047 | Lumbar laminectomy for spinal stenosis | 14.99 | 90 days |
| 29888 | Arthroscopic ACL reconstruction | 13.94 | 90 days |
| 63030 | Lumbar discectomy (removing herniated disc material pressing on a nerve) | 11.70 | 90 days |
| 25607 | Surgical fixation (ORIF) of a distal radius fracture | 9.32 | 90 days |
| 28296 | Bunion correction with bone realignment (metatarsal osteotomy) | 8.04 | 90 days |
| 29881 | Knee arthroscopy with removal of torn meniscus (one compartment) | 6.85 | 90 days |
| 25605 | Setting a broken wrist (distal radius) without surgery, with manipulation | 6.09 | 90 days |
| 28285 | Hammertoe correction | 5.48 | 90 days |
| 64721 | Carpal tunnel release | 4.85 | 90 days |
| 26055 | Trigger finger release | 3.03 | 90 days |
| 29826 | Shoulder arthroscopy with subacromial decompression (add-on code) | 2.93 | add-on |
| 99204 | New patient office visit, higher complexity | 2.60 | n/a |
| 99214 | Established patient office visit, higher complexity | 1.92 | n/a |
| 62323 | Lumbar/caudal epidural steroid injection with imaging guidance | 1.76 | 0 days |
| 99203 | New patient office visit, moderate complexity | 1.60 | n/a |
| 27096 | Sacroiliac (SI) joint injection with imaging | 1.44 | 0 days |
| 99213 | Established patient office visit, moderate complexity | 1.30 | n/a |
| 20611 | Major joint injection with ultrasound guidance | 1.07 | 0 days |
| 20610 | Injection or aspiration of a major joint (knee, hip, shoulder), no imaging | 0.77 | 0 days |
| 20550 | Injection of a tendon sheath or ligament | 0.73 | 0 days |
Surgeons look these values up for one reason: compensation models run on them. A typical employed orthopedic contract pays a dollar rate per wRVU generated, so annual production times that rate is the paycheck math. A worked example for a joint-replacement-heavy practice:
Two operational notes hiding in that math. First, the office-visit line is enormous: clinic volume, not the OR, often decides whether a surgeon hits production targets, which is why unanswered phones are a production problem. Second, 90-day global periods mean post-op visits generate no separate wRVU, so filling clinic slots with bundled follow-ups instead of new patients quietly starves production. Our global periods guide covers the scheduling side of that problem.
A work RVU (relative value unit) is Medicare's measure of the physician work in a service: the time, skill, and intensity involved. Total RVUs also include practice expense and malpractice components, but compensation models almost always run on the work RVU alone.
Most employed and hospital-affiliated compensation models pay a dollar conversion factor per wRVU generated, often against a base salary draw. Annual wRVUs times the contract's dollar-per-wRVU rate, benchmarked against specialty survey percentiles, drives the number.
CMS revises the Physician Fee Schedule annually, and specialty societies petition for revaluations. Always verify against the current-year PFS before contract math; the values here reflect the CY2026 fee schedule.
No. CPT descriptors are AMA-copyrighted, so this table uses plain-language descriptions of each procedure. The codes and wRVU values themselves are public CMS fee schedule data.
CPT 27447 (total knee replacement) carries 19.11 work RVUs under the CY2026 CMS Physician Fee Schedule, the same as total hip replacement (27130). Both have a 90-day global period, so routine post-op visits in that window earn no separate wRVU.
20610, injection or aspiration of a major joint such as the knee without imaging, is 0.77 work RVUs. 20611, the same injection with ultrasound guidance, is 1.07. Both have a 0-day global period.
On this table, single-level posterolateral lumbar fusion (22612) is highest at 22.94, followed by total shoulder replacement (23472) at 21.58 and total knee and total hip replacement (27447, 27130) at 19.11 each. The table covers high-volume orthopedic and spine codes, not every CPT code.
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