CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 35261 RVU and Medicare Payment (2026)
Rpr blvsl grf oth/thn vn nck — 18.49 work RVU, about $897.48 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 18.49
- PE RVU (non-facility)
- 3.65
- PE RVU (facility)
- 3.65
- MP RVU
- 4.73
- Office payment
- $897.48
- Facility payment
- $897.48
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 35261 in a non-facility setting with national GPCI: (18.49 + 3.65 + 4.73) × $33.4009 ≈ $897.48. The same code in a facility setting pays about $897.48 because facility PE RVU (3.65) replaces office PE RVU.
What changes by locality
GPCI moves 35261 non-facility payment from $783.04 to $1,144.04 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 35261?
18.49. 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 35261 in 2026?
About $897.48 non-facility ($897.48 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 (18.49) and malpractice RVU stay fixed; only practice expense changes (3.65 office vs 3.65 facility). That is the entire office-vs-facility payment gap.