CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49495 RVU and Medicare Payment (2026)
Rpr ing hernia baby reduc — 6.05 work RVU, about $399.47 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.05
- PE RVU (non-facility)
- 4.29
- PE RVU (facility)
- 4.29
- MP RVU
- 1.62
- Office payment
- $399.47
- Facility payment
- $399.47
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 49495 in a non-facility setting with national GPCI: (6.05 + 4.29 + 1.62) × $33.4009 ≈ $399.47. The same code in a facility setting pays about $399.47 because facility PE RVU (4.29) replaces office PE RVU.
What changes by locality
GPCI moves 49495 non-facility payment from $353.03 to $488.08 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 49495?
6.05. 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 49495 in 2026?
About $399.47 non-facility ($399.47 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 (6.05) and malpractice RVU stay fixed; only practice expense changes (4.29 office vs 4.29 facility). That is the entire office-vs-facility payment gap.