CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 19100 RVU and Medicare Payment (2026)
Bx breast percut w/o image — 1.24 work RVU, about $163.33 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.24
- PE RVU (non-facility)
- 3.35
- PE RVU (facility)
- 0.31
- MP RVU
- 0.3
- Office payment
- $163.33
- Facility payment
- $61.79
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 19100 in a non-facility setting with national GPCI: (1.24 + 3.35 + 0.3) × $33.4009 ≈ $163.33. The same code in a facility setting pays about $61.79 because facility PE RVU (0.31) replaces office PE RVU.
What changes by locality
GPCI moves 19100 non-facility payment from $142.69 to $212.69 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 19100?
1.24. 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 19100 in 2026?
About $163.33 non-facility ($61.79 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 (1.24) and malpractice RVU stay fixed; only practice expense changes (3.35 office vs 0.31 facility). That is the entire office-vs-facility payment gap.