CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49255 RVU and Medicare Payment (2026)
Removal of omentum — 12.25 work RVU, about $751.85 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 12.25
- PE RVU (non-facility)
- 7.4
- PE RVU (facility)
- 7.4
- MP RVU
- 2.86
- Office payment
- $751.85
- Facility payment
- $751.85
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 49255 in a non-facility setting with national GPCI: (12.25 + 7.4 + 2.86) × $33.4009 ≈ $751.85. The same code in a facility setting pays about $751.85 because facility PE RVU (7.4) replaces office PE RVU.
What changes by locality
GPCI moves 49255 non-facility payment from $670.67 to $929.61 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 49255?
12.25. 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 49255 in 2026?
About $751.85 non-facility ($751.85 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 (12.25) and malpractice RVU stay fixed; only practice expense changes (7.4 office vs 7.4 facility). That is the entire office-vs-facility payment gap.