CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21175 RVU and Medicare Payment (2026)
Rcnst bfrnt sp orb rm&lw fhd — 32.72 work RVU, about $1,931.91 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 32.72
- PE RVU (non-facility)
- 19.04
- PE RVU (facility)
- 19.04
- MP RVU
- 6.08
- Office payment
- $1,931.91
- Facility payment
- $1,931.91
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 21175 in a non-facility setting with national GPCI: (32.72 + 19.04 + 6.08) × $33.4009 ≈ $1,931.91. The same code in a facility setting pays about $1,931.91 because facility PE RVU (19.04) replaces office PE RVU.
What changes by locality
GPCI moves 21175 non-facility payment from $1,743.75 to $2,428.5 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 21175?
32.72. 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 21175 in 2026?
About $1,931.91 non-facility ($1,931.91 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 (32.72) and malpractice RVU stay fixed; only practice expense changes (19.04 office vs 19.04 facility). That is the entire office-vs-facility payment gap.