CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49501 RVU and Medicare Payment (2026)
Rpr ing hernia init blocked — 9.13 work RVU, about $586.52 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.13
- PE RVU (non-facility)
- 5.99
- PE RVU (facility)
- 5.99
- MP RVU
- 2.44
- Office payment
- $586.52
- Facility payment
- $586.52
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 49501 in a non-facility setting with national GPCI: (9.13 + 5.99 + 2.44) × $33.4009 ≈ $586.52. The same code in a facility setting pays about $586.52 because facility PE RVU (5.99) replaces office PE RVU.
What changes by locality
GPCI moves 49501 non-facility payment from $518.78 to $719.33 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 49501?
9.13. 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 49501 in 2026?
About $586.52 non-facility ($586.52 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 (9.13) and malpractice RVU stay fixed; only practice expense changes (5.99 office vs 5.99 facility). That is the entire office-vs-facility payment gap.