CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31

CPT 61800 RVU and Medicare Payment (2026)

Apply srs headframe add-on — 2.19 work RVU, about $145.63 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
2.19
PE RVU (non-facility)
1.25
PE RVU (facility)
1.25
MP RVU
0.92
Office payment
$145.63
Facility payment
$145.63

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 61800 in a non-facility setting with national GPCI: (2.19 + 1.25 + 0.92) × $33.4009 ≈ $145.63. The same code in a facility setting pays about $145.63 because facility PE RVU (1.25) replaces office PE RVU.

What changes by locality

GPCI moves 61800 non-facility payment from $122.61 to $194.32 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 61800?

2.19. 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 61800 in 2026?

About $145.63 non-facility ($145.63 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 (2.19) 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.