CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21445 RVU and Medicare Payment (2026)
Optx mndblr/max alv ridge fx — 6.1 work RVU, about $753.19 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.1
- PE RVU (non-facility)
- 15.76
- PE RVU (facility)
- 10.18
- MP RVU
- 0.69
- Office payment
- $753.19
- Facility payment
- $566.81
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 21445 in a non-facility setting with national GPCI: (6.1 + 15.76 + 0.69) × $33.4009 ≈ $753.19. The same code in a facility setting pays about $566.81 because facility PE RVU (10.18) replaces office PE RVU.
What changes by locality
GPCI moves 21445 non-facility payment from $667.79 to $997.58 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 21445?
6.1. 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 21445 in 2026?
About $753.19 non-facility ($566.81 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 (6.1) and malpractice RVU stay fixed; only practice expense changes (15.76 office vs 10.18 facility). That is the entire office-vs-facility payment gap.