CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 69801 RVU and Medicare Payment (2026)
Incise inner ear — 2.01 work RVU, about $223.12 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.01
- PE RVU (non-facility)
- 4.38
- PE RVU (facility)
- 0.92
- MP RVU
- 0.29
- Office payment
- $223.12
- Facility payment
- $107.55
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 69801 in a non-facility setting with national GPCI: (2.01 + 4.38 + 0.29) × $33.4009 ≈ $223.12. The same code in a facility setting pays about $107.55 because facility PE RVU (0.92) replaces office PE RVU.
What changes by locality
GPCI moves 69801 non-facility payment from $197.79 to $290.67 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 69801?
2.01. 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 69801 in 2026?
About $223.12 non-facility ($107.55 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 (2.01) and malpractice RVU stay fixed; only practice expense changes (4.38 office vs 0.92 facility). That is the entire office-vs-facility payment gap.