CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 35211 RVU and Medicare Payment (2026)
Rpr blvsl dir ntrathrc w/byp — 23.97 work RVU, about $1,320.34 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 23.97
- PE RVU (non-facility)
- 9.63
- PE RVU (facility)
- 9.63
- MP RVU
- 5.93
- Office payment
- $1,320.34
- Facility payment
- $1,320.34
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 35211 in a non-facility setting with national GPCI: (23.97 + 9.63 + 5.93) × $33.4009 ≈ $1,320.34. The same code in a facility setting pays about $1,320.34 because facility PE RVU (9.63) replaces office PE RVU.
What changes by locality
GPCI moves 35211 non-facility payment from $1,169.77 to $1,652.62 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 35211?
23.97. 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 35211 in 2026?
About $1,320.34 non-facility ($1,320.34 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 (23.97) and malpractice RVU stay fixed; only practice expense changes (9.63 office vs 9.63 facility). That is the entire office-vs-facility payment gap.