CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49555 RVU and Medicare Payment (2026)
Rerepair fem hernia reduce — 9.16 work RVU, about $583.51 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.16
- PE RVU (non-facility)
- 5.85
- PE RVU (facility)
- 5.85
- MP RVU
- 2.46
- Office payment
- $583.51
- Facility payment
- $583.51
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 49555 in a non-facility setting with national GPCI: (9.16 + 5.85 + 2.46) × $33.4009 ≈ $583.51. The same code in a facility setting pays about $583.51 because facility PE RVU (5.85) replaces office PE RVU.
What changes by locality
GPCI moves 49555 non-facility payment from $516.11 to $717.16 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 49555?
9.16. 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 49555 in 2026?
About $583.51 non-facility ($583.51 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 (9.16) and malpractice RVU stay fixed; only practice expense changes (5.85 office vs 5.85 facility). That is the entire office-vs-facility payment gap.