CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49596 RVU and Medicare Payment (2026)
Rpr aa hrn 1st > 10 ncr/strn — 18.2 work RVU, about $936.56 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 18.2
- PE RVU (non-facility)
- 5.11
- PE RVU (facility)
- 5.11
- MP RVU
- 4.73
- Office payment
- $936.56
- Facility payment
- $936.56
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 49596 in a non-facility setting with national GPCI: (18.2 + 5.11 + 4.73) × $33.4009 ≈ $936.56. The same code in a facility setting pays about $936.56 because facility PE RVU (5.11) replaces office PE RVU.
What changes by locality
GPCI moves 49596 non-facility payment from $820.07 to $1,185.12 across CMS localities — from Wisconsin 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 49596?
18.2. 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 49596 in 2026?
About $936.56 non-facility ($936.56 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 (18.2) and malpractice RVU stay fixed; only practice expense changes (5.11 office vs 5.11 facility). That is the entire office-vs-facility payment gap.