CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 52001 RVU and Medicare Payment (2026)
Cysto w/irrg&evac mlt clots — 5.3 work RVU, about $419.52 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.3
- PE RVU (non-facility)
- 6.58
- PE RVU (facility)
- 1.59
- MP RVU
- 0.68
- Office payment
- $419.52
- Facility payment
- $252.84
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 52001 in a non-facility setting with national GPCI: (5.3 + 6.58 + 0.68) × $33.4009 ≈ $419.52. The same code in a facility setting pays about $252.84 because facility PE RVU (1.59) replaces office PE RVU.
What changes by locality
GPCI moves 52001 non-facility payment from $377.51 to $525.59 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 52001?
5.3. 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 52001 in 2026?
About $419.52 non-facility ($252.84 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 (5.3) and malpractice RVU stay fixed; only practice expense changes (6.58 office vs 1.59 facility). That is the entire office-vs-facility payment gap.