CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 54318 RVU and Medicare Payment (2026)
Reconstruction of urethra — 12.12 work RVU, about $647.31 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 12.12
- PE RVU (non-facility)
- 5.7
- PE RVU (facility)
- 5.7
- MP RVU
- 1.56
- Office payment
- $647.31
- Facility payment
- $647.31
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 54318 in a non-facility setting with national GPCI: (12.12 + 5.7 + 1.56) × $33.4009 ≈ $647.31. The same code in a facility setting pays about $647.31 because facility PE RVU (5.7) replaces office PE RVU.
What changes by locality
GPCI moves 54318 non-facility payment from $595.19 to $838.7 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 54318?
12.12. 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 54318 in 2026?
About $647.31 non-facility ($647.31 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 (12.12) and malpractice RVU stay fixed; only practice expense changes (5.7 office vs 5.7 facility). That is the entire office-vs-facility payment gap.