CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 46260 RVU and Medicare Payment (2026)
Remove in/ex hem groups 2+ — 6.56 work RVU, about $479.64 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.56
- PE RVU (non-facility)
- 6.46
- PE RVU (facility)
- 6.46
- MP RVU
- 1.34
- Office payment
- $479.64
- Facility payment
- $479.64
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 46260 in a non-facility setting with national GPCI: (6.56 + 6.46 + 1.34) × $33.4009 ≈ $479.64. The same code in a facility setting pays about $479.64 because facility PE RVU (6.46) replaces office PE RVU.
What changes by locality
GPCI moves 46260 non-facility payment from $427.51 to $583.12 across CMS localities — from Arkansas 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 46260?
6.56. 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 46260 in 2026?
About $479.64 non-facility ($479.64 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 (6.56) and malpractice RVU stay fixed; only practice expense changes (6.46 office vs 6.46 facility). That is the entire office-vs-facility payment gap.