CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49428 RVU and Medicare Payment (2026)
Ligation of shunt — 6.7 work RVU, about $411.5 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.7
- PE RVU (non-facility)
- 3.84
- PE RVU (facility)
- 3.84
- MP RVU
- 1.78
- Office payment
- $411.5
- Facility payment
- $411.5
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 49428 in a non-facility setting with national GPCI: (6.7 + 3.84 + 1.78) × $33.4009 ≈ $411.5. The same code in a facility setting pays about $411.5 because facility PE RVU (3.84) replaces office PE RVU.
What changes by locality
GPCI moves 49428 non-facility payment from $364.58 to $507.66 across CMS localities — from Arkansas to Miami. 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 49428?
6.7. 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 49428 in 2026?
About $411.5 non-facility ($411.5 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 (6.7) and malpractice RVU stay fixed; only practice expense changes (3.84 office vs 3.84 facility). That is the entire office-vs-facility payment gap.