CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 59866 RVU and Medicare Payment (2026)
Abortion (mpr) — 3.89 work RVU, about $213.43 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.89
- PE RVU (non-facility)
- 1.25
- PE RVU (facility)
- 1.25
- MP RVU
- 1.25
- Office payment
- $213.43
- Facility payment
- $213.43
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 59866 in a non-facility setting with national GPCI: (3.89 + 1.25 + 1.25) × $33.4009 ≈ $213.43. The same code in a facility setting pays about $213.43 because facility PE RVU (1.25) replaces office PE RVU.
What changes by locality
GPCI moves 59866 non-facility payment from $182.79 to $278.98 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 59866?
3.89. 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 59866 in 2026?
About $213.43 non-facility ($213.43 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 (3.89) and malpractice RVU stay fixed; only practice expense changes (1.25 office vs 1.25 facility). That is the entire office-vs-facility payment gap.