CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49616 RVU and Medicare Payment (2026)
Rpr aa hrn rcr 3-10 ncr/strn — 15.16 work RVU, about $783.25 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 15.16
- PE RVU (non-facility)
- 4.34
- PE RVU (facility)
- 4.34
- MP RVU
- 3.95
- Office payment
- $783.25
- Facility payment
- $783.25
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 49616 in a non-facility setting with national GPCI: (15.16 + 4.34 + 3.95) × $33.4009 ≈ $783.25. The same code in a facility setting pays about $783.25 because facility PE RVU (4.34) replaces office PE RVU.
What changes by locality
GPCI moves 49616 non-facility payment from $685.86 to $990.92 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 49616?
15.16. 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 49616 in 2026?
About $783.25 non-facility ($783.25 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 (15.16) and malpractice RVU stay fixed; only practice expense changes (4.34 office vs 4.34 facility). That is the entire office-vs-facility payment gap.