CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21151 RVU and Medicare Payment (2026)
Rcnstj mdfc lefrtii w/b1 grf — 28.29 work RVU, about $1,553.81 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 28.29
- PE RVU (non-facility)
- 14.1
- PE RVU (facility)
- 14.1
- MP RVU
- 4.13
- Office payment
- $1,553.81
- Facility payment
- $1,553.81
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 21151 in a non-facility setting with national GPCI: (28.29 + 14.1 + 4.13) × $33.4009 ≈ $1,553.81. The same code in a facility setting pays about $1,553.81 because facility PE RVU (14.1) replaces office PE RVU.
What changes by locality
GPCI moves 21151 non-facility payment from $1,420.5 to $1,994.94 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 21151?
28.29. 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 21151 in 2026?
About $1,553.81 non-facility ($1,553.81 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 (28.29) and malpractice RVU stay fixed; only practice expense changes (14.1 office vs 14.1 facility). That is the entire office-vs-facility payment gap.