CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21936 RVU and Medicare Payment (2026)
Resect back tum 5 cm/> — 21.99 work RVU, about $1,307.98 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 21.99
- PE RVU (non-facility)
- 11.94
- PE RVU (facility)
- 11.94
- MP RVU
- 5.23
- Office payment
- $1,307.98
- Facility payment
- $1,307.98
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 21936 in a non-facility setting with national GPCI: (21.99 + 11.94 + 5.23) × $33.4009 ≈ $1,307.98. The same code in a facility setting pays about $1,307.98 because facility PE RVU (11.94) replaces office PE RVU.
What changes by locality
GPCI moves 21936 non-facility payment from $1,167.02 to $1,622.71 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 21936?
21.99. 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 21936 in 2026?
About $1,307.98 non-facility ($1,307.98 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 (21.99) and malpractice RVU stay fixed; only practice expense changes (11.94 office vs 11.94 facility). That is the entire office-vs-facility payment gap.