CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21235 RVU and Medicare Payment (2026)
Ear cartilage graft — 7.31 work RVU, about $737.16 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 7.31
- PE RVU (non-facility)
- 13.74
- PE RVU (facility)
- 6.82
- MP RVU
- 1.02
- Office payment
- $737.16
- Facility payment
- $506.02
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 21235 in a non-facility setting with national GPCI: (7.31 + 13.74 + 1.02) × $33.4009 ≈ $737.16. The same code in a facility setting pays about $506.02 because facility PE RVU (6.82) replaces office PE RVU.
What changes by locality
GPCI moves 21235 non-facility payment from $655.93 to $951.05 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 21235?
7.31. 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 21235 in 2026?
About $737.16 non-facility ($506.02 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 (7.31) and malpractice RVU stay fixed; only practice expense changes (13.74 office vs 6.82 facility). That is the entire office-vs-facility payment gap.