CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49605 RVU and Medicare Payment (2026)
Repair umbilical lesion — 84.91 work RVU, about $4,491.09 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 84.91
- PE RVU (non-facility)
- 26.81
- PE RVU (facility)
- 26.81
- MP RVU
- 22.74
- Office payment
- $4,491.09
- Facility payment
- $4,491.09
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 49605 in a non-facility setting with national GPCI: (84.91 + 26.81 + 22.74) × $33.4009 ≈ $4,491.09. The same code in a facility setting pays about $4,491.09 because facility PE RVU (26.81) replaces office PE RVU.
What changes by locality
GPCI moves 49605 non-facility payment from $3,927.88 to $5,689.13 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 49605?
84.91. 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 49605 in 2026?
About $4,491.09 non-facility ($4,491.09 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 (84.91) and malpractice RVU stay fixed; only practice expense changes (26.81 office vs 26.81 facility). That is the entire office-vs-facility payment gap.