CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 35221 RVU and Medicare Payment (2026)
Rpr bld vsl dir intra-abdl — 25.95 work RVU, about $1,338.37 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 25.95
- PE RVU (non-facility)
- 7.58
- PE RVU (facility)
- 7.58
- MP RVU
- 6.54
- Office payment
- $1,338.37
- Facility payment
- $1,338.37
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 35221 in a non-facility setting with national GPCI: (25.95 + 7.58 + 6.54) × $33.4009 ≈ $1,338.37. The same code in a facility setting pays about $1,338.37 because facility PE RVU (7.58) replaces office PE RVU.
What changes by locality
GPCI moves 35221 non-facility payment from $1,176.58 to $1,690.13 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 35221?
25.95. 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 35221 in 2026?
About $1,338.37 non-facility ($1,338.37 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 (25.95) and malpractice RVU stay fixed; only practice expense changes (7.58 office vs 7.58 facility). That is the entire office-vs-facility payment gap.