CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 55881 RVU and Medicare Payment (2026)
Ablt trurl prst8 tis thrm us — 9.56 work RVU, about $9,270.42 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.56
- PE RVU (non-facility)
- 266.75
- PE RVU (facility)
- 2.06
- MP RVU
- 1.24
- Office payment
- $9,270.42
- Facility payment
- $429.54
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 55881 in a non-facility setting with national GPCI: (9.56 + 266.75 + 1.24) × $33.4009 ≈ $9,270.42. The same code in a facility setting pays about $429.54 because facility PE RVU (2.06) replaces office PE RVU.
What changes by locality
GPCI moves 55881 non-facility payment from $7,994.07 to $13,224.41 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 55881?
9.56. 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 55881 in 2026?
About $9,270.42 non-facility ($429.54 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 (9.56) and malpractice RVU stay fixed; only practice expense changes (266.75 office vs 2.06 facility). That is the entire office-vs-facility payment gap.