CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 59612 RVU and Medicare Payment (2026)
Vbac delivery only — 16.09 work RVU, about $823.33 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 16.09
- PE RVU (non-facility)
- 3.41
- PE RVU (facility)
- 3.41
- MP RVU
- 5.15
- Office payment
- $823.33
- Facility payment
- $823.33
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 59612 in a non-facility setting with national GPCI: (16.09 + 3.41 + 5.15) × $33.4009 ≈ $823.33. The same code in a facility setting pays about $823.33 because facility PE RVU (3.41) replaces office PE RVU.
What changes by locality
GPCI moves 59612 non-facility payment from $699.51 to $1,091.01 across CMS localities — from Wisconsin to Miami. 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 59612?
16.09. 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 59612 in 2026?
About $823.33 non-facility ($823.33 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 (16.09) and malpractice RVU stay fixed; only practice expense changes (3.41 office vs 3.41 facility). That is the entire office-vs-facility payment gap.