CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31

CPT 36251 RVU and Medicare Payment (2026)

Ins cath ren art 1st unilat — 4.97 work RVU, about $1,226.15 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
4.97
PE RVU (non-facility)
30.79
PE RVU (facility)
0.8
MP RVU
0.95
Office payment
$1,226.15
Facility payment
$224.45

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 36251 in a non-facility setting with national GPCI: (4.97 + 30.79 + 0.95) × $33.4009 ≈ $1,226.15. The same code in a facility setting pays about $224.45 because facility PE RVU (0.8) replaces office PE RVU.

What changes by locality

GPCI moves 36251 non-facility payment from $1,065.75 to $1,684.24 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 36251?

4.97. 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 36251 in 2026?

About $1,226.15 non-facility ($224.45 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 (4.97) and malpractice RVU stay fixed; only practice expense changes (30.79 office vs 0.8 facility). That is the entire office-vs-facility payment gap.