CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 53260 RVU and Medicare Payment (2026)
Treatment of urethra lesion — 2.95 work RVU, about $213.77 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.95
- PE RVU (non-facility)
- 3.02
- PE RVU (facility)
- 1.58
- MP RVU
- 0.43
- Office payment
- $213.77
- Facility payment
- $165.67
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 53260 in a non-facility setting with national GPCI: (2.95 + 3.02 + 0.43) × $33.4009 ≈ $213.77. The same code in a facility setting pays about $165.67 because facility PE RVU (1.58) replaces office PE RVU.
What changes by locality
GPCI moves 53260 non-facility payment from $192.58 to $263.14 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 53260?
2.95. 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 53260 in 2026?
About $213.77 non-facility ($165.67 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 (2.95) and malpractice RVU stay fixed; only practice expense changes (3.02 office vs 1.58 facility). That is the entire office-vs-facility payment gap.