CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 54304 RVU and Medicare Payment (2026)
Revision of penis — 12.95 work RVU, about $676.03 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 12.95
- PE RVU (non-facility)
- 5.63
- PE RVU (facility)
- 5.63
- MP RVU
- 1.66
- Office payment
- $676.03
- Facility payment
- $676.03
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 54304 in a non-facility setting with national GPCI: (12.95 + 5.63 + 1.66) × $33.4009 ≈ $676.03. The same code in a facility setting pays about $676.03 because facility PE RVU (5.63) replaces office PE RVU.
What changes by locality
GPCI moves 54304 non-facility payment from $622.63 to $879.63 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 54304?
12.95. 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 54304 in 2026?
About $676.03 non-facility ($676.03 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 (12.95) and malpractice RVU stay fixed; only practice expense changes (5.63 office vs 5.63 facility). That is the entire office-vs-facility payment gap.