CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21554 RVU and Medicare Payment (2026)
Exc neck tum deep 5 cm/> — 10.85 work RVU, about $680.71 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 10.85
- PE RVU (non-facility)
- 7.14
- PE RVU (facility)
- 7.14
- MP RVU
- 2.39
- Office payment
- $680.71
- Facility payment
- $680.71
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 21554 in a non-facility setting with national GPCI: (10.85 + 7.14 + 2.39) × $33.4009 ≈ $680.71. The same code in a facility setting pays about $680.71 because facility PE RVU (7.14) replaces office PE RVU.
What changes by locality
GPCI moves 21554 non-facility payment from $608.37 to $841.57 across CMS localities — from Arkansas to Alaska. 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 21554?
10.85. 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 21554 in 2026?
About $680.71 non-facility ($680.71 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 (10.85) and malpractice RVU stay fixed; only practice expense changes (7.14 office vs 7.14 facility). That is the entire office-vs-facility payment gap.