CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 54163 RVU and Medicare Payment (2026)
Repair of circumcision — 3.24 work RVU, about $207.09 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.24
- PE RVU (non-facility)
- 2.54
- PE RVU (facility)
- 2.54
- MP RVU
- 0.42
- Office payment
- $207.09
- Facility payment
- $207.09
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 54163 in a non-facility setting with national GPCI: (3.24 + 2.54 + 0.42) × $33.4009 ≈ $207.09. The same code in a facility setting pays about $207.09 because facility PE RVU (2.54) replaces office PE RVU.
What changes by locality
GPCI moves 54163 non-facility payment from $188.32 to $260.41 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 54163?
3.24. 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 54163 in 2026?
About $207.09 non-facility ($207.09 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 (3.24) and malpractice RVU stay fixed; only practice expense changes (2.54 office vs 2.54 facility). That is the entire office-vs-facility payment gap.