CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 55866 RVU and Medicare Payment (2026)
Laps surg prst8ect rpbic rad — 21.9 work RVU, about $1,081.86 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 21.9
- PE RVU (non-facility)
- 7.66
- PE RVU (facility)
- 7.66
- MP RVU
- 2.83
- Office payment
- $1,081.86
- Facility payment
- $1,081.86
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 55866 in a non-facility setting with national GPCI: (21.9 + 7.66 + 2.83) × $33.4009 ≈ $1,081.86. The same code in a facility setting pays about $1,081.86 because facility PE RVU (7.66) replaces office PE RVU.
What changes by locality
GPCI moves 55866 non-facility payment from $999.94 to $1,421.78 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 55866?
21.9. 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 55866 in 2026?
About $1,081.86 non-facility ($1,081.86 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 (21.9) and malpractice RVU stay fixed; only practice expense changes (7.66 office vs 7.66 facility). That is the entire office-vs-facility payment gap.