CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 65426 RVU and Medicare Payment (2026)
Removal of eye lesion — 5.9 work RVU, about $670.69 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.9
- PE RVU (non-facility)
- 13.72
- PE RVU (facility)
- 6.01
- MP RVU
- 0.46
- Office payment
- $670.69
- Facility payment
- $413.17
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 65426 in a non-facility setting with national GPCI: (5.9 + 13.72 + 0.46) × $33.4009 ≈ $670.69. The same code in a facility setting pays about $413.17 because facility PE RVU (6.01) replaces office PE RVU.
What changes by locality
GPCI moves 65426 non-facility payment from $598.62 to $887.79 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 65426?
5.9. 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 65426 in 2026?
About $670.69 non-facility ($413.17 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 (5.9) and malpractice RVU stay fixed; only practice expense changes (13.72 office vs 6.01 facility). That is the entire office-vs-facility payment gap.