CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 35180 RVU and Medicare Payment (2026)
Rpr cgen av fistula head&nck — 14.72 work RVU, about $717.12 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 14.72
- PE RVU (non-facility)
- 3
- PE RVU (facility)
- 3
- MP RVU
- 3.75
- Office payment
- $717.12
- Facility payment
- $717.12
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 35180 in a non-facility setting with national GPCI: (14.72 + 3 + 3.75) × $33.4009 ≈ $717.12. The same code in a facility setting pays about $717.12 because facility PE RVU (3) replaces office PE RVU.
What changes by locality
GPCI moves 35180 non-facility payment from $626.23 to $913.22 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 35180?
14.72. 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 35180 in 2026?
About $717.12 non-facility ($717.12 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 (14.72) and malpractice RVU stay fixed; only practice expense changes (3 office vs 3 facility). That is the entire office-vs-facility payment gap.