CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 55100 RVU and Medicare Payment (2026)
Drainage of scrotum abscess — 2.39 work RVU, about $248.17 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.39
- PE RVU (non-facility)
- 4.66
- PE RVU (facility)
- 2.14
- MP RVU
- 0.38
- Office payment
- $248.17
- Facility payment
- $164
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 55100 in a non-facility setting with national GPCI: (2.39 + 4.66 + 0.38) × $33.4009 ≈ $248.17. The same code in a facility setting pays about $164 because facility PE RVU (2.14) replaces office PE RVU.
What changes by locality
GPCI moves 55100 non-facility payment from $220.07 to $319.86 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 55100?
2.39. 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 55100 in 2026?
About $248.17 non-facility ($164 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 (2.39) and malpractice RVU stay fixed; only practice expense changes (4.66 office vs 2.14 facility). That is the entire office-vs-facility payment gap.