CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21452 RVU and Medicare Payment (2026)
Perq tx mndblr fx xtrnl fixj — 2.34 work RVU, about $765.55 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.34
- PE RVU (non-facility)
- 20.23
- PE RVU (facility)
- 11.06
- MP RVU
- 0.35
- Office payment
- $765.55
- Facility payment
- $459.26
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 21452 in a non-facility setting with national GPCI: (2.34 + 20.23 + 0.35) × $33.4009 ≈ $765.55. The same code in a facility setting pays about $459.26 because facility PE RVU (11.06) replaces office PE RVU.
What changes by locality
GPCI moves 21452 non-facility payment from $664.61 to $1,067.38 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 21452?
2.34. 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 21452 in 2026?
About $765.55 non-facility ($459.26 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 (2.34) and malpractice RVU stay fixed; only practice expense changes (20.23 office vs 11.06 facility). That is the entire office-vs-facility payment gap.