CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 26055 RVU and Medicare Payment (2026)
Incise finger tendon sheath — 3.03 work RVU, about $629.61 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.03
- PE RVU (non-facility)
- 15.24
- PE RVU (facility)
- 5
- MP RVU
- 0.58
- Office payment
- $629.61
- Facility payment
- $287.58
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 26055 in a non-facility setting with national GPCI: (3.03 + 15.24 + 0.58) × $33.4009 ≈ $629.61. The same code in a facility setting pays about $287.58 because facility PE RVU (5) replaces office PE RVU.
What changes by locality
GPCI moves 26055 non-facility payment from $548.44 to $856.74 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 26055?
3.03. 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 26055 in 2026?
About $629.61 non-facility ($287.58 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 (3.03) and malpractice RVU stay fixed; only practice expense changes (15.24 office vs 5 facility). That is the entire office-vs-facility payment gap.