CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 59300 RVU and Medicare Payment (2026)
Episiotomy or vaginal repair — 2.35 work RVU, about $225.46 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.35
- PE RVU (non-facility)
- 3.64
- PE RVU (facility)
- 0.89
- MP RVU
- 0.76
- Office payment
- $225.46
- Facility payment
- $133.6
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 59300 in a non-facility setting with national GPCI: (2.35 + 3.64 + 0.76) × $33.4009 ≈ $225.46. The same code in a facility setting pays about $133.6 because facility PE RVU (0.89) replaces office PE RVU.
What changes by locality
GPCI moves 59300 non-facility payment from $196 to $276.05 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 59300?
2.35. 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 59300 in 2026?
About $225.46 non-facility ($133.6 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 (2.35) and malpractice RVU stay fixed; only practice expense changes (3.64 office vs 0.89 facility). That is the entire office-vs-facility payment gap.