CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49900 RVU and Medicare Payment (2026)
Repair of abdominal wall — 12.1 work RVU, about $800.29 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 12.1
- PE RVU (non-facility)
- 8.82
- PE RVU (facility)
- 8.82
- MP RVU
- 3.04
- Office payment
- $800.29
- Facility payment
- $800.29
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 49900 in a non-facility setting with national GPCI: (12.1 + 8.82 + 3.04) × $33.4009 ≈ $800.29. The same code in a facility setting pays about $800.29 because facility PE RVU (8.82) replaces office PE RVU.
What changes by locality
GPCI moves 49900 non-facility payment from $709.5 to $975.92 across CMS localities — from Arkansas to Alaska. 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 49900?
12.1. 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 49900 in 2026?
About $800.29 non-facility ($800.29 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 (12.1) and malpractice RVU stay fixed; only practice expense changes (8.82 office vs 8.82 facility). That is the entire office-vs-facility payment gap.