CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 58100 RVU and Medicare Payment (2026)
Biopsy of uterus lining — 1.18 work RVU, about $98.2 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.18
- PE RVU (non-facility)
- 1.55
- PE RVU (facility)
- 0.26
- MP RVU
- 0.21
- Office payment
- $98.2
- Facility payment
- $55.11
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 58100 in a non-facility setting with national GPCI: (1.18 + 1.55 + 0.21) × $33.4009 ≈ $98.2. The same code in a facility setting pays about $55.11 because facility PE RVU (0.26) replaces office PE RVU.
What changes by locality
GPCI moves 58100 non-facility payment from $87.5 to $122.16 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 58100?
1.18. 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 58100 in 2026?
About $98.2 non-facility ($55.11 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 (1.18) and malpractice RVU stay fixed; only practice expense changes (1.55 office vs 0.26 facility). That is the entire office-vs-facility payment gap.