CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 54105 RVU and Medicare Payment (2026)
Biopsy of penis — 3.45 work RVU, about $285.91 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.45
- PE RVU (non-facility)
- 4.67
- PE RVU (facility)
- 1.96
- MP RVU
- 0.44
- Office payment
- $285.91
- Facility payment
- $195.4
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 54105 in a non-facility setting with national GPCI: (3.45 + 4.67 + 0.44) × $33.4009 ≈ $285.91. The same code in a facility setting pays about $195.4 because facility PE RVU (1.96) replaces office PE RVU.
What changes by locality
GPCI moves 54105 non-facility payment from $256.79 to $360.71 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 54105?
3.45. 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 54105 in 2026?
About $285.91 non-facility ($195.4 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 (3.45) and malpractice RVU stay fixed; only practice expense changes (4.67 office vs 1.96 facility). That is the entire office-vs-facility payment gap.