CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 50431 RVU and Medicare Payment (2026)
Njx px nfrosgrm &/urtrgrm — 1.07 work RVU, about $307.96 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.07
- PE RVU (non-facility)
- 8.03
- PE RVU (facility)
- 0.58
- MP RVU
- 0.12
- Office payment
- $307.96
- Facility payment
- $59.12
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 50431 in a non-facility setting with national GPCI: (1.07 + 8.03 + 0.12) × $33.4009 ≈ $307.96. The same code in a facility setting pays about $59.12 because facility PE RVU (0.58) replaces office PE RVU.
What changes by locality
GPCI moves 50431 non-facility payment from $268.19 to $428.58 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 50431?
1.07. 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 50431 in 2026?
About $307.96 non-facility ($59.12 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 (1.07) and malpractice RVU stay fixed; only practice expense changes (8.03 office vs 0.58 facility). That is the entire office-vs-facility payment gap.