CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49189 RVU and Medicare Payment (2026)
Opn exc/dst ntra-abd 20.1-30 — 39 work RVU, about $2,147.34 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 39
- PE RVU (non-facility)
- 16.29
- PE RVU (facility)
- 16.29
- MP RVU
- 9
- Office payment
- $2,147.34
- Facility payment
- $2,147.34
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 49189 in a non-facility setting with national GPCI: (39 + 16.29 + 9) × $33.4009 ≈ $2,147.34. The same code in a facility setting pays about $2,147.34 because facility PE RVU (16.29) replaces office PE RVU.
What changes by locality
GPCI moves 49189 non-facility payment from $1,916.47 to $2,699.05 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 49189?
39. 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 49189 in 2026?
About $2,147.34 non-facility ($2,147.34 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 (39) and malpractice RVU stay fixed; only practice expense changes (16.29 office vs 16.29 facility). That is the entire office-vs-facility payment gap.