CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 54500 RVU and Medicare Payment (2026)
Biopsy of testis — 1.28 work RVU, about $67.14 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.28
- PE RVU (non-facility)
- 0.57
- PE RVU (facility)
- 0.57
- MP RVU
- 0.16
- Office payment
- $67.14
- Facility payment
- $67.14
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 54500 in a non-facility setting with national GPCI: (1.28 + 0.57 + 0.16) × $33.4009 ≈ $67.14. The same code in a facility setting pays about $67.14 because facility PE RVU (0.57) replaces office PE RVU.
What changes by locality
GPCI moves 54500 non-facility payment from $61.86 to $87.35 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 54500?
1.28. 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 54500 in 2026?
About $67.14 non-facility ($67.14 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 (1.28) and malpractice RVU stay fixed; only practice expense changes (0.57 office vs 0.57 facility). That is the entire office-vs-facility payment gap.