CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49600 RVU and Medicare Payment (2026)
Repair umbilical lesion — 11.26 work RVU, about $703.76 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 11.26
- PE RVU (non-facility)
- 6.8
- PE RVU (facility)
- 6.8
- MP RVU
- 3.01
- Office payment
- $703.76
- Facility payment
- $703.76
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 49600 in a non-facility setting with national GPCI: (11.26 + 6.8 + 3.01) × $33.4009 ≈ $703.76. The same code in a facility setting pays about $703.76 because facility PE RVU (6.8) replaces office PE RVU.
What changes by locality
GPCI moves 49600 non-facility payment from $622.97 to $866.79 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 49600?
11.26. 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 49600 in 2026?
About $703.76 non-facility ($703.76 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 (11.26) and malpractice RVU stay fixed; only practice expense changes (6.8 office vs 6.8 facility). That is the entire office-vs-facility payment gap.