CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21172 RVU and Medicare Payment (2026)
Rcnst supr-lat orb rm&lw fhd — 27.5 work RVU, about $2,089.23 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 27.5
- PE RVU (non-facility)
- 23.42
- PE RVU (facility)
- 23.42
- MP RVU
- 11.63
- Office payment
- $2,089.23
- Facility payment
- $2,089.23
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 21172 in a non-facility setting with national GPCI: (27.5 + 23.42 + 11.63) × $33.4009 ≈ $2,089.23. The same code in a facility setting pays about $2,089.23 because facility PE RVU (23.42) replaces office PE RVU.
What changes by locality
GPCI moves 21172 non-facility payment from $1,787.38 to $2,715.24 across CMS localities — from Nebraska to Miami. 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 21172?
27.5. 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 21172 in 2026?
About $2,089.23 non-facility ($2,089.23 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 (27.5) and malpractice RVU stay fixed; only practice expense changes (23.42 office vs 23.42 facility). That is the entire office-vs-facility payment gap.