CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 69700 RVU and Medicare Payment (2026)
Close mastoid fistula — 8.16 work RVU, about $598.21 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 8.16
- PE RVU (non-facility)
- 8.54
- PE RVU (facility)
- 8.54
- MP RVU
- 1.21
- Office payment
- $598.21
- Facility payment
- $598.21
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 69700 in a non-facility setting with national GPCI: (8.16 + 8.54 + 1.21) × $33.4009 ≈ $598.21. The same code in a facility setting pays about $598.21 because facility PE RVU (8.54) replaces office PE RVU.
What changes by locality
GPCI moves 69700 non-facility payment from $538.39 to $735.52 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 69700?
8.16. 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 69700 in 2026?
About $598.21 non-facility ($598.21 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 (8.16) and malpractice RVU stay fixed; only practice expense changes (8.54 office vs 8.54 facility). That is the entire office-vs-facility payment gap.