CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 68770 RVU and Medicare Payment (2026)
Close tear system fistula — 8.08 work RVU, about $535.42 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 8.08
- PE RVU (non-facility)
- 7.31
- PE RVU (facility)
- 7.31
- MP RVU
- 0.64
- Office payment
- $535.42
- Facility payment
- $535.42
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 68770 in a non-facility setting with national GPCI: (8.08 + 7.31 + 0.64) × $33.4009 ≈ $535.42. The same code in a facility setting pays about $535.42 because facility PE RVU (7.31) replaces office PE RVU.
What changes by locality
GPCI moves 68770 non-facility payment from $490.62 to $676.63 across CMS localities — from Arkansas to Alaska. 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 68770?
8.08. 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 68770 in 2026?
About $535.42 non-facility ($535.42 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 (8.08) and malpractice RVU stay fixed; only practice expense changes (7.31 office vs 7.31 facility). That is the entire office-vs-facility payment gap.