CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 57250 RVU and Medicare Payment (2026)
Repair rectum & vagina — 9.83 work RVU, about $545.44 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.83
- PE RVU (non-facility)
- 4.85
- PE RVU (facility)
- 4.85
- MP RVU
- 1.65
- Office payment
- $545.44
- Facility payment
- $545.44
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 57250 in a non-facility setting with national GPCI: (9.83 + 4.85 + 1.65) × $33.4009 ≈ $545.44. The same code in a facility setting pays about $545.44 because facility PE RVU (4.85) replaces office PE RVU.
What changes by locality
GPCI moves 57250 non-facility payment from $495.87 to $695.39 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 57250?
9.83. 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 57250 in 2026?
About $545.44 non-facility ($545.44 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 (9.83) and malpractice RVU stay fixed; only practice expense changes (4.85 office vs 4.85 facility). That is the entire office-vs-facility payment gap.