CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21603 RVU and Medicare Payment (2026)
Exc ch wal tum w/lymphadec — 24.54 work RVU, about $1,672.05 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 24.54
- PE RVU (non-facility)
- 19.34
- PE RVU (facility)
- 19.34
- MP RVU
- 6.18
- Office payment
- $1,672.05
- Facility payment
- $1,672.05
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 21603 in a non-facility setting with national GPCI: (24.54 + 19.34 + 6.18) × $33.4009 ≈ $1,672.05. The same code in a facility setting pays about $1,672.05 because facility PE RVU (19.34) replaces office PE RVU.
What changes by locality
GPCI moves 21603 non-facility payment from $1,480.85 to $2,031.18 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 21603?
24.54. 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 21603 in 2026?
About $1,672.05 non-facility ($1,672.05 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 (24.54) and malpractice RVU stay fixed; only practice expense changes (19.34 office vs 19.34 facility). That is the entire office-vs-facility payment gap.