CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 51065 RVU and Medicare Payment (2026)
Remove ureter calculus — 9.7 work RVU, about $530.07 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.7
- PE RVU (non-facility)
- 4.92
- PE RVU (facility)
- 4.92
- MP RVU
- 1.25
- Office payment
- $530.07
- Facility payment
- $530.07
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 51065 in a non-facility setting with national GPCI: (9.7 + 4.92 + 1.25) × $33.4009 ≈ $530.07. The same code in a facility setting pays about $530.07 because facility PE RVU (4.92) replaces office PE RVU.
What changes by locality
GPCI moves 51065 non-facility payment from $486.65 to $684 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 51065?
9.7. 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 51065 in 2026?
About $530.07 non-facility ($530.07 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 (9.7) and malpractice RVU stay fixed; only practice expense changes (4.92 office vs 4.92 facility). That is the entire office-vs-facility payment gap.