CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21485 RVU and Medicare Payment (2026)
Cltx tmprmand dislc comp — 4.65 work RVU, about $1,001.69 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 4.65
- PE RVU (non-facility)
- 24.67
- PE RVU (facility)
- 17.77
- MP RVU
- 0.67
- Office payment
- $1,001.69
- Facility payment
- $771.23
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 21485 in a non-facility setting with national GPCI: (4.65 + 24.67 + 0.67) × $33.4009 ≈ $1,001.69. The same code in a facility setting pays about $771.23 because facility PE RVU (17.77) replaces office PE RVU.
What changes by locality
GPCI moves 21485 non-facility payment from $874.66 to $1,372.6 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 21485?
4.65. 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 21485 in 2026?
About $1,001.69 non-facility ($771.23 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 (4.65) and malpractice RVU stay fixed; only practice expense changes (24.67 office vs 17.77 facility). That is the entire office-vs-facility payment gap.