CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 54316 RVU and Medicare Payment (2026)
Reconstruction of urethra — 17.6 work RVU, about $892.81 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 17.6
- PE RVU (non-facility)
- 6.87
- PE RVU (facility)
- 6.87
- MP RVU
- 2.26
- Office payment
- $892.81
- Facility payment
- $892.81
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 54316 in a non-facility setting with national GPCI: (17.6 + 6.87 + 2.26) × $33.4009 ≈ $892.81. The same code in a facility setting pays about $892.81 because facility PE RVU (6.87) replaces office PE RVU.
What changes by locality
GPCI moves 54316 non-facility payment from $823.84 to $1,167.76 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 54316?
17.6. 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 54316 in 2026?
About $892.81 non-facility ($892.81 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 (17.6) and malpractice RVU stay fixed; only practice expense changes (6.87 office vs 6.87 facility). That is the entire office-vs-facility payment gap.