CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 59160 RVU and Medicare Payment (2026)
D & c after delivery — 2.69 work RVU, about $263.53 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.69
- PE RVU (non-facility)
- 4.33
- PE RVU (facility)
- 1.46
- MP RVU
- 0.87
- Office payment
- $263.53
- Facility payment
- $167.67
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 59160 in a non-facility setting with national GPCI: (2.69 + 4.33 + 0.87) × $33.4009 ≈ $263.53. The same code in a facility setting pays about $167.67 because facility PE RVU (1.46) replaces office PE RVU.
What changes by locality
GPCI moves 59160 non-facility payment from $229.05 to $323.86 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 59160?
2.69. 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 59160 in 2026?
About $263.53 non-facility ($167.67 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 (2.69) and malpractice RVU stay fixed; only practice expense changes (4.33 office vs 1.46 facility). That is the entire office-vs-facility payment gap.