CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 64804 RVU and Medicare Payment (2026)
Sympathectomy cervicothorac — 15.51 work RVU, about $1,199.43 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 15.51
- PE RVU (non-facility)
- 13.86
- PE RVU (facility)
- 13.86
- MP RVU
- 6.54
- Office payment
- $1,199.43
- Facility payment
- $1,199.43
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 64804 in a non-facility setting with national GPCI: (15.51 + 13.86 + 6.54) × $33.4009 ≈ $1,199.43. The same code in a facility setting pays about $1,199.43 because facility PE RVU (13.86) replaces office PE RVU.
What changes by locality
GPCI moves 64804 non-facility payment from $1,027.91 to $1,552.4 across CMS localities — from Nebraska 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 64804?
15.51. 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 64804 in 2026?
About $1,199.43 non-facility ($1,199.43 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 (15.51) and malpractice RVU stay fixed; only practice expense changes (13.86 office vs 13.86 facility). That is the entire office-vs-facility payment gap.