CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49553 RVU and Medicare Payment (2026)
Rpr fem hernia init blocked — 9.67 work RVU, about $608.9 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.67
- PE RVU (non-facility)
- 6.04
- PE RVU (facility)
- 6.04
- MP RVU
- 2.52
- Office payment
- $608.9
- Facility payment
- $608.9
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 49553 in a non-facility setting with national GPCI: (9.67 + 6.04 + 2.52) × $33.4009 ≈ $608.9. The same code in a facility setting pays about $608.9 because facility PE RVU (6.04) replaces office PE RVU.
What changes by locality
GPCI moves 49553 non-facility payment from $539.63 to $745.87 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 49553?
9.67. 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 49553 in 2026?
About $608.9 non-facility ($608.9 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 (9.67) and malpractice RVU stay fixed; only practice expense changes (6.04 office vs 6.04 facility). That is the entire office-vs-facility payment gap.