CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 54535 RVU and Medicare Payment (2026)
Extensive testis surgery — 12.86 work RVU, about $673.7 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 12.86
- PE RVU (non-facility)
- 5.66
- PE RVU (facility)
- 5.66
- MP RVU
- 1.65
- Office payment
- $673.7
- Facility payment
- $673.7
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 54535 in a non-facility setting with national GPCI: (12.86 + 5.66 + 1.65) × $33.4009 ≈ $673.7. The same code in a facility setting pays about $673.7 because facility PE RVU (5.66) replaces office PE RVU.
What changes by locality
GPCI moves 54535 non-facility payment from $620.31 to $876.01 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 54535?
12.86. 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 54535 in 2026?
About $673.7 non-facility ($673.7 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 (12.86) and malpractice RVU stay fixed; only practice expense changes (5.66 office vs 5.66 facility). That is the entire office-vs-facility payment gap.