CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 15630 RVU and Medicare Payment (2026)
Delay flap eye/nos/ear/lip — 3.98 work RVU, about $469.95 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.98
- PE RVU (non-facility)
- 9.55
- PE RVU (facility)
- 4.8
- MP RVU
- 0.54
- Office payment
- $469.95
- Facility payment
- $311.3
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 15630 in a non-facility setting with national GPCI: (3.98 + 9.55 + 0.54) × $33.4009 ≈ $469.95. The same code in a facility setting pays about $311.3 because facility PE RVU (4.8) replaces office PE RVU.
What changes by locality
GPCI moves 15630 non-facility payment from $416.23 to $617.19 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 15630?
3.98. 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 15630 in 2026?
About $469.95 non-facility ($311.3 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 (3.98) and malpractice RVU stay fixed; only practice expense changes (9.55 office vs 4.8 facility). That is the entire office-vs-facility payment gap.