CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 53449 RVU and Medicare Payment (2026)
Repair uro sphincter — 10.3 work RVU, about $559.47 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 10.3
- PE RVU (non-facility)
- 5.12
- PE RVU (facility)
- 5.12
- MP RVU
- 1.33
- Office payment
- $559.47
- Facility payment
- $559.47
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 53449 in a non-facility setting with national GPCI: (10.3 + 5.12 + 1.33) × $33.4009 ≈ $559.47. The same code in a facility setting pays about $559.47 because facility PE RVU (5.12) replaces office PE RVU.
What changes by locality
GPCI moves 53449 non-facility payment from $513.81 to $722.65 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 53449?
10.3. 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 53449 in 2026?
About $559.47 non-facility ($559.47 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 (10.3) and malpractice RVU stay fixed; only practice expense changes (5.12 office vs 5.12 facility). That is the entire office-vs-facility payment gap.