CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 17264 RVU and Medicare Payment (2026)
Dstrj mal les t/a/l 3.1-4.0 — 1.94 work RVU, about $202.08 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.94
- PE RVU (non-facility)
- 3.92
- PE RVU (facility)
- 1.14
- MP RVU
- 0.19
- Office payment
- $202.08
- Facility payment
- $109.22
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 17264 in a non-facility setting with national GPCI: (1.94 + 3.92 + 0.19) × $33.4009 ≈ $202.08. The same code in a facility setting pays about $109.22 because facility PE RVU (1.14) replaces office PE RVU.
What changes by locality
GPCI moves 17264 non-facility payment from $180.54 to $264.13 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 17264?
1.94. 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 17264 in 2026?
About $202.08 non-facility ($109.22 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 (1.94) and malpractice RVU stay fixed; only practice expense changes (3.92 office vs 1.14 facility). That is the entire office-vs-facility payment gap.