CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49505 RVU and Medicare Payment (2026)
Prp i/hern init reduc >5 yr — 7.76 work RVU, about $508.03 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 7.76
- PE RVU (non-facility)
- 5.4
- PE RVU (facility)
- 5.4
- MP RVU
- 2.05
- Office payment
- $508.03
- Facility payment
- $508.03
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 49505 in a non-facility setting with national GPCI: (7.76 + 5.4 + 2.05) × $33.4009 ≈ $508.03. The same code in a facility setting pays about $508.03 because facility PE RVU (5.4) replaces office PE RVU.
What changes by locality
GPCI moves 49505 non-facility payment from $449.39 to $620.12 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 49505?
7.76. 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 49505 in 2026?
About $508.03 non-facility ($508.03 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 (7.76) and malpractice RVU stay fixed; only practice expense changes (5.4 office vs 5.4 facility). That is the entire office-vs-facility payment gap.