CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 55874 RVU and Medicare Payment (2026)
Tprnl plmt biodegrdabl matrl — 2.95 work RVU, about $3,704.49 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.95
- PE RVU (non-facility)
- 107.63
- PE RVU (facility)
- 0.99
- MP RVU
- 0.33
- Office payment
- $3,704.49
- Facility payment
- $142.62
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 55874 in a non-facility setting with national GPCI: (2.95 + 107.63 + 0.33) × $33.4009 ≈ $3,704.49. The same code in a facility setting pays about $142.62 because facility PE RVU (0.99) replaces office PE RVU.
What changes by locality
GPCI moves 55874 non-facility payment from $3,192.26 to $5,299.18 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 55874?
2.95. 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 55874 in 2026?
About $3,704.49 non-facility ($142.62 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 (2.95) and malpractice RVU stay fixed; only practice expense changes (107.63 office vs 0.99 facility). That is the entire office-vs-facility payment gap.