CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 11004 RVU and Medicare Payment (2026)
Dbrdmt skin xtrnl gent&per — 10.53 work RVU, about $504.69 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 10.53
- PE RVU (non-facility)
- 2.46
- PE RVU (facility)
- 2.46
- MP RVU
- 2.12
- Office payment
- $504.69
- Facility payment
- $504.69
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 11004 in a non-facility setting with national GPCI: (10.53 + 2.46 + 2.12) × $33.4009 ≈ $504.69. The same code in a facility setting pays about $504.69 because facility PE RVU (2.46) replaces office PE RVU.
What changes by locality
GPCI moves 11004 non-facility payment from $452.24 to $654.09 across CMS localities — from Wisconsin to Alaska. 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 11004?
10.53. 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 11004 in 2026?
About $504.69 non-facility ($504.69 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 (10.53) and malpractice RVU stay fixed; only practice expense changes (2.46 office vs 2.46 facility). That is the entire office-vs-facility payment gap.