CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 59821 RVU and Medicare Payment (2026)
Treatment of miscarriage — 4.96 work RVU, about $427.53 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 4.96
- PE RVU (non-facility)
- 6.25
- PE RVU (facility)
- 3.75
- MP RVU
- 1.59
- Office payment
- $427.53
- Facility payment
- $344.03
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 59821 in a non-facility setting with national GPCI: (4.96 + 6.25 + 1.59) × $33.4009 ≈ $427.53. The same code in a facility setting pays about $344.03 because facility PE RVU (3.75) replaces office PE RVU.
What changes by locality
GPCI moves 59821 non-facility payment from $372.34 to $523.1 across CMS localities — from Arkansas to Nyc Suburbs/long Island. 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 59821?
4.96. 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 59821 in 2026?
About $427.53 non-facility ($344.03 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 (4.96) and malpractice RVU stay fixed; only practice expense changes (6.25 office vs 3.75 facility). That is the entire office-vs-facility payment gap.