CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 55535 RVU and Medicare Payment (2026)
Revise spermatic cord veins — 7.01 work RVU, about $397.8 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 7.01
- PE RVU (non-facility)
- 3.99
- PE RVU (facility)
- 3.99
- MP RVU
- 0.91
- Office payment
- $397.8
- Facility payment
- $397.8
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 55535 in a non-facility setting with national GPCI: (7.01 + 3.99 + 0.91) × $33.4009 ≈ $397.8. The same code in a facility setting pays about $397.8 because facility PE RVU (3.99) replaces office PE RVU.
What changes by locality
GPCI moves 55535 non-facility payment from $364.27 to $509.89 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 55535?
7.01. 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 55535 in 2026?
About $397.8 non-facility ($397.8 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 (7.01) and malpractice RVU stay fixed; only practice expense changes (3.99 office vs 3.99 facility). That is the entire office-vs-facility payment gap.