CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 69155 RVU and Medicare Payment (2026)
Extensive ear/neck surgery — 22.77 work RVU, about $1,431.23 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 22.77
- PE RVU (non-facility)
- 16.76
- PE RVU (facility)
- 16.76
- MP RVU
- 3.32
- Office payment
- $1,431.23
- Facility payment
- $1,431.23
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 69155 in a non-facility setting with national GPCI: (22.77 + 16.76 + 3.32) × $33.4009 ≈ $1,431.23. The same code in a facility setting pays about $1,431.23 because facility PE RVU (16.76) replaces office PE RVU.
What changes by locality
GPCI moves 69155 non-facility payment from $1,298.51 to $1,798.09 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 69155?
22.77. 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 69155 in 2026?
About $1,431.23 non-facility ($1,431.23 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 (22.77) and malpractice RVU stay fixed; only practice expense changes (16.76 office vs 16.76 facility). That is the entire office-vs-facility payment gap.