CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21501 RVU and Medicare Payment (2026)
I&d dp absc/hmtma sft ts nck — 3.88 work RVU, about $517.71 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.88
- PE RVU (non-facility)
- 10.79
- PE RVU (facility)
- 5.1
- MP RVU
- 0.83
- Office payment
- $517.71
- Facility payment
- $327.66
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 21501 in a non-facility setting with national GPCI: (3.88 + 10.79 + 0.83) × $33.4009 ≈ $517.71. The same code in a facility setting pays about $327.66 because facility PE RVU (5.1) replaces office PE RVU.
What changes by locality
GPCI moves 21501 non-facility payment from $453.45 to $678.4 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 21501?
3.88. 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 21501 in 2026?
About $517.71 non-facility ($327.66 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 (3.88) and malpractice RVU stay fixed; only practice expense changes (10.79 office vs 5.1 facility). That is the entire office-vs-facility payment gap.