CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 31237 RVU and Medicare Payment (2026)
Nsl/sins ndsc surg bx polypc — 2.54 work RVU, about $266.54 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.54
- PE RVU (non-facility)
- 5.07
- PE RVU (facility)
- 1.23
- MP RVU
- 0.37
- Office payment
- $266.54
- Facility payment
- $138.28
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 31237 in a non-facility setting with national GPCI: (2.54 + 5.07 + 0.37) × $33.4009 ≈ $266.54. The same code in a facility setting pays about $138.28 because facility PE RVU (1.23) replaces office PE RVU.
What changes by locality
GPCI moves 31237 non-facility payment from $236.67 to $344.99 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 31237?
2.54. 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 31237 in 2026?
About $266.54 non-facility ($138.28 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 (2.54) and malpractice RVU stay fixed; only practice expense changes (5.07 office vs 1.23 facility). That is the entire office-vs-facility payment gap.