CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 35188 RVU and Medicare Payment (2026)
Rpr acq av fistula head&neck — 17.55 work RVU, about $1,263.22 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 17.55
- PE RVU (non-facility)
- 12.86
- PE RVU (facility)
- 12.86
- MP RVU
- 7.41
- Office payment
- $1,263.22
- Facility payment
- $1,263.22
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 35188 in a non-facility setting with national GPCI: (17.55 + 12.86 + 7.41) × $33.4009 ≈ $1,263.22. The same code in a facility setting pays about $1,263.22 because facility PE RVU (12.86) replaces office PE RVU.
What changes by locality
GPCI moves 35188 non-facility payment from $1,073.91 to $1,659.26 across CMS localities — from Wisconsin to Miami. 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 35188?
17.55. 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 35188 in 2026?
About $1,263.22 non-facility ($1,263.22 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 (17.55) and malpractice RVU stay fixed; only practice expense changes (12.86 office vs 12.86 facility). That is the entire office-vs-facility payment gap.