CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 55868 RVU and Medicare Payment (2026)
Lap srg prst8ct lymph nod bx — 22.46 work RVU, about $1,107.57 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 22.46
- PE RVU (non-facility)
- 7.79
- PE RVU (facility)
- 7.79
- MP RVU
- 2.91
- Office payment
- $1,107.57
- Facility payment
- $1,107.57
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 55868 in a non-facility setting with national GPCI: (22.46 + 7.79 + 2.91) × $33.4009 ≈ $1,107.57. The same code in a facility setting pays about $1,107.57 because facility PE RVU (7.79) replaces office PE RVU.
What changes by locality
GPCI moves 55868 non-facility payment from $1,023.75 to $1,455.94 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 55868?
22.46. 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 55868 in 2026?
About $1,107.57 non-facility ($1,107.57 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 (22.46) and malpractice RVU stay fixed; only practice expense changes (7.79 office vs 7.79 facility). That is the entire office-vs-facility payment gap.