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

CPT 69603 RVU and Medicare Payment (2026)

Revj mstdc rsltg rad mstdc — 13.85 work RVU, about $1,175.38 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
13.85
PE RVU (non-facility)
19.32
PE RVU (facility)
19.32
MP RVU
2.02
Office payment
$1,175.38
Facility payment
$1,175.38

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 69603 in a non-facility setting with national GPCI: (13.85 + 19.32 + 2.02) × $33.4009 ≈ $1,175.38. The same code in a facility setting pays about $1,175.38 because facility PE RVU (19.32) replaces office PE RVU.

What changes by locality

GPCI moves 69603 non-facility payment from $1,051.67 to $1,480.18 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 69603?

13.85. 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 69603 in 2026?

About $1,175.38 non-facility ($1,175.38 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 (13.85) and malpractice RVU stay fixed; only practice expense changes (19.32 office vs 19.32 facility). That is the entire office-vs-facility payment gap.