CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21076 RVU and Medicare Payment (2026)
Impres&prep surg obt prosth — 13.07 work RVU, about $919.86 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 13.07
- PE RVU (non-facility)
- 12.8
- PE RVU (facility)
- 4.07
- MP RVU
- 1.67
- Office payment
- $919.86
- Facility payment
- $628.27
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 21076 in a non-facility setting with national GPCI: (13.07 + 12.8 + 1.67) × $33.4009 ≈ $919.86. The same code in a facility setting pays about $628.27 because facility PE RVU (4.07) replaces office PE RVU.
What changes by locality
GPCI moves 21076 non-facility payment from $832.53 to $1,140.88 across CMS localities — from Arkansas 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 21076?
13.07. 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 21076 in 2026?
About $919.86 non-facility ($628.27 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 (13.07) and malpractice RVU stay fixed; only practice expense changes (12.8 office vs 4.07 facility). That is the entire office-vs-facility payment gap.