CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21346 RVU and Medicare Payment (2026)
Opn tx nasomax fx w/fixj — 11.16 work RVU, about $913.85 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 11.16
- PE RVU (non-facility)
- 14.57
- PE RVU (facility)
- 14.57
- MP RVU
- 1.63
- Office payment
- $913.85
- Facility payment
- $913.85
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 21346 in a non-facility setting with national GPCI: (11.16 + 14.57 + 1.63) × $33.4009 ≈ $913.85. The same code in a facility setting pays about $913.85 because facility PE RVU (14.57) replaces office PE RVU.
What changes by locality
GPCI moves 21346 non-facility payment from $818.83 to $1,144.69 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 21346?
11.16. 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 21346 in 2026?
About $913.85 non-facility ($913.85 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 (11.16) and malpractice RVU stay fixed; only practice expense changes (14.57 office vs 14.57 facility). That is the entire office-vs-facility payment gap.