CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 31253 RVU and Medicare Payment (2026)
Nsl/sins ndsc total — 8.78 work RVU, about $420.18 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 8.78
- PE RVU (non-facility)
- 2.51
- PE RVU (facility)
- 2.51
- MP RVU
- 1.29
- Office payment
- $420.18
- Facility payment
- $420.18
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 31253 in a non-facility setting with national GPCI: (8.78 + 2.51 + 1.29) × $33.4009 ≈ $420.18. The same code in a facility setting pays about $420.18 because facility PE RVU (2.51) replaces office PE RVU.
What changes by locality
GPCI moves 31253 non-facility payment from $386.85 to $552.92 across CMS localities — from Wisconsin 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 31253?
8.78. 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 31253 in 2026?
About $420.18 non-facility ($420.18 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 (8.78) and malpractice RVU stay fixed; only practice expense changes (2.51 office vs 2.51 facility). That is the entire office-vs-facility payment gap.