CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 57130 RVU and Medicare Payment (2026)
Excision vaginal septum — 2.4 work RVU, about $222.12 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.4
- PE RVU (non-facility)
- 3.83
- PE RVU (facility)
- 1.79
- MP RVU
- 0.42
- Office payment
- $222.12
- Facility payment
- $153.98
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 57130 in a non-facility setting with national GPCI: (2.4 + 3.83 + 0.42) × $33.4009 ≈ $222.12. The same code in a facility setting pays about $153.98 because facility PE RVU (1.79) replaces office PE RVU.
What changes by locality
GPCI moves 57130 non-facility payment from $197.27 to $280.97 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 57130?
2.4. 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 57130 in 2026?
About $222.12 non-facility ($153.98 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 (2.4) and malpractice RVU stay fixed; only practice expense changes (3.83 office vs 1.79 facility). That is the entire office-vs-facility payment gap.