CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 39503 RVU and Medicare Payment (2026)
Repair of diaphragm hernia — 106.19 work RVU, about $5,352.49 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 106.19
- PE RVU (non-facility)
- 27.29
- PE RVU (facility)
- 27.29
- MP RVU
- 26.77
- Office payment
- $5,352.49
- Facility payment
- $5,352.49
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 39503 in a non-facility setting with national GPCI: (106.19 + 27.29 + 26.77) × $33.4009 ≈ $5,352.49. The same code in a facility setting pays about $5,352.49 because facility PE RVU (27.29) replaces office PE RVU.
What changes by locality
GPCI moves 39503 non-facility payment from $4,695.46 to $6,783.69 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 39503?
106.19. 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 39503 in 2026?
About $5,352.49 non-facility ($5,352.49 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 (106.19) and malpractice RVU stay fixed; only practice expense changes (27.29 office vs 27.29 facility). That is the entire office-vs-facility payment gap.