CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 46250 RVU and Medicare Payment (2026)
Remove ext hem groups 2+ — 4.14 work RVU, about $536.75 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 4.14
- PE RVU (non-facility)
- 11.09
- PE RVU (facility)
- 4.56
- MP RVU
- 0.84
- Office payment
- $536.75
- Facility payment
- $318.64
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 46250 in a non-facility setting with national GPCI: (4.14 + 11.09 + 0.84) × $33.4009 ≈ $536.75. The same code in a facility setting pays about $318.64 because facility PE RVU (4.56) replaces office PE RVU.
What changes by locality
GPCI moves 46250 non-facility payment from $470.92 to $702.67 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 46250?
4.14. 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 46250 in 2026?
About $536.75 non-facility ($318.64 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 (4.14) and malpractice RVU stay fixed; only practice expense changes (11.09 office vs 4.56 facility). That is the entire office-vs-facility payment gap.