CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 53430 RVU and Medicare Payment (2026)
Reconstruction of urethra — 16.99 work RVU, about $873.1 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 16.99
- PE RVU (non-facility)
- 6.71
- PE RVU (facility)
- 6.71
- MP RVU
- 2.44
- Office payment
- $873.1
- Facility payment
- $873.1
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 53430 in a non-facility setting with national GPCI: (16.99 + 6.71 + 2.44) × $33.4009 ≈ $873.1. The same code in a facility setting pays about $873.1 because facility PE RVU (6.71) replaces office PE RVU.
What changes by locality
GPCI moves 53430 non-facility payment from $801.97 to $1,134.82 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 53430?
16.99. 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 53430 in 2026?
About $873.1 non-facility ($873.1 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 (16.99) and malpractice RVU stay fixed; only practice expense changes (6.71 office vs 6.71 facility). That is the entire office-vs-facility payment gap.