CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31

CPT 21336 RVU and Medicare Payment (2026)

Open tx septal fx w/wo stabj — 6.6 work RVU, about $583.18 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
6.6
PE RVU (non-facility)
9.88
PE RVU (facility)
9.88
MP RVU
0.98
Office payment
$583.18
Facility payment
$583.18

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 21336 in a non-facility setting with national GPCI: (6.6 + 9.88 + 0.98) × $33.4009 ≈ $583.18. The same code in a facility setting pays about $583.18 because facility PE RVU (9.88) replaces office PE RVU.

What changes by locality

GPCI moves 21336 non-facility payment from $520.77 to $738.1 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 21336?

6.6. 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 21336 in 2026?

About $583.18 non-facility ($583.18 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 (6.6) and malpractice RVU stay fixed; only practice expense changes (9.88 office vs 9.88 facility). That is the entire office-vs-facility payment gap.