CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49500 RVU and Medicare Payment (2026)
Rpr ing hernia init reduce — 5.69 work RVU, about $412.5 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.69
- PE RVU (non-facility)
- 5.15
- PE RVU (facility)
- 5.15
- MP RVU
- 1.51
- Office payment
- $412.5
- Facility payment
- $412.5
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 49500 in a non-facility setting with national GPCI: (5.69 + 5.15 + 1.51) × $33.4009 ≈ $412.5. The same code in a facility setting pays about $412.5 because facility PE RVU (5.15) replaces office PE RVU.
What changes by locality
GPCI moves 49500 non-facility payment from $363.79 to $500.4 across CMS localities — from Arkansas to Nyc Suburbs/long Island. 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 49500?
5.69. 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 49500 in 2026?
About $412.5 non-facility ($412.5 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 (5.69) and malpractice RVU stay fixed; only practice expense changes (5.15 office vs 5.15 facility). That is the entire office-vs-facility payment gap.