CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49610 RVU and Medicare Payment (2026)
Repair umbilical lesion — 10.64 work RVU, about $662.67 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 10.64
- PE RVU (non-facility)
- 6.36
- PE RVU (facility)
- 6.36
- MP RVU
- 2.84
- Office payment
- $662.67
- Facility payment
- $662.67
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 49610 in a non-facility setting with national GPCI: (10.64 + 6.36 + 2.84) × $33.4009 ≈ $662.67. The same code in a facility setting pays about $662.67 because facility PE RVU (6.36) replaces office PE RVU.
What changes by locality
GPCI moves 49610 non-facility payment from $586.71 to $816.42 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 49610?
10.64. 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 49610 in 2026?
About $662.67 non-facility ($662.67 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 (10.64) and malpractice RVU stay fixed; only practice expense changes (6.36 office vs 6.36 facility). That is the entire office-vs-facility payment gap.