CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49613 RVU and Medicare Payment (2026)
Rpr aa hrn rcr < 3 rdc — 7.23 work RVU, about $387.12 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 7.23
- PE RVU (non-facility)
- 2.5
- PE RVU (facility)
- 2.5
- MP RVU
- 1.86
- Office payment
- $387.12
- Facility payment
- $387.12
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 49613 in a non-facility setting with national GPCI: (7.23 + 2.5 + 1.86) × $33.4009 ≈ $387.12. The same code in a facility setting pays about $387.12 because facility PE RVU (2.5) replaces office PE RVU.
What changes by locality
GPCI moves 49613 non-facility payment from $340.62 to $485.53 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 49613?
7.23. 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 49613 in 2026?
About $387.12 non-facility ($387.12 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 (7.23) and malpractice RVU stay fixed; only practice expense changes (2.5 office vs 2.5 facility). That is the entire office-vs-facility payment gap.