CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 53240 RVU and Medicare Payment (2026)
Surgery for urethra pouch — 6.9 work RVU, about $392.13 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.9
- PE RVU (non-facility)
- 3.95
- PE RVU (facility)
- 3.95
- MP RVU
- 0.89
- Office payment
- $392.13
- Facility payment
- $392.13
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 53240 in a non-facility setting with national GPCI: (6.9 + 3.95 + 0.89) × $33.4009 ≈ $392.13. The same code in a facility setting pays about $392.13 because facility PE RVU (3.95) replaces office PE RVU.
What changes by locality
GPCI moves 53240 non-facility payment from $359.11 to $502.59 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 53240?
6.9. 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 53240 in 2026?
About $392.13 non-facility ($392.13 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 (6.9) and malpractice RVU stay fixed; only practice expense changes (3.95 office vs 3.95 facility). That is the entire office-vs-facility payment gap.