CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21080 RVU and Medicare Payment (2026)
Impres&prep def obt prosth — 24.43 work RVU, about $1,729.83 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 24.43
- PE RVU (non-facility)
- 24.45
- PE RVU (facility)
- 7.48
- MP RVU
- 2.91
- Office payment
- $1,729.83
- Facility payment
- $1,163.02
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 21080 in a non-facility setting with national GPCI: (24.43 + 24.45 + 2.91) × $33.4009 ≈ $1,729.83. The same code in a facility setting pays about $1,163.02 because facility PE RVU (7.48) replaces office PE RVU.
What changes by locality
GPCI moves 21080 non-facility payment from $1,567.54 to $2,147.27 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 21080?
24.43. 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 21080 in 2026?
About $1,729.83 non-facility ($1,163.02 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 (24.43) and malpractice RVU stay fixed; only practice expense changes (24.45 office vs 7.48 facility). That is the entire office-vs-facility payment gap.