CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 55801 RVU and Medicare Payment (2026)
Removal of prostate — 19.31 work RVU, about $983.32 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 19.31
- PE RVU (non-facility)
- 7.65
- PE RVU (facility)
- 7.65
- MP RVU
- 2.48
- Office payment
- $983.32
- Facility payment
- $983.32
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 55801 in a non-facility setting with national GPCI: (19.31 + 7.65 + 2.48) × $33.4009 ≈ $983.32. The same code in a facility setting pays about $983.32 because facility PE RVU (7.65) replaces office PE RVU.
What changes by locality
GPCI moves 55801 non-facility payment from $907.12 to $1,285.22 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 55801?
19.31. 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 55801 in 2026?
About $983.32 non-facility ($983.32 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 (19.31) and malpractice RVU stay fixed; only practice expense changes (7.65 office vs 7.65 facility). That is the entire office-vs-facility payment gap.