CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31

CPT 57421 RVU and Medicare Payment (2026)

Exam/biopsy of vag w/scope — 2.15 work RVU, about $182.03 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
2.15
PE RVU (non-facility)
2.88
PE RVU (facility)
0.7
MP RVU
0.42
Office payment
$182.03
Facility payment
$109.22

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 57421 in a non-facility setting with national GPCI: (2.15 + 2.88 + 0.42) × $33.4009 ≈ $182.03. The same code in a facility setting pays about $109.22 because facility PE RVU (0.7) replaces office PE RVU.

What changes by locality

GPCI moves 57421 non-facility payment from $161.67 to $225.94 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 57421?

2.15. 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 57421 in 2026?

About $182.03 non-facility ($109.22 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 (2.15) and malpractice RVU stay fixed; only practice expense changes (2.88 office vs 0.7 facility). That is the entire office-vs-facility payment gap.