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

CPT 78740 RVU and Medicare Payment (2026)

Ureteral reflux study — 0.56 work RVU, about $220.78 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
0.56
PE RVU (non-facility)
5.99
PE RVU (facility)
5.99
MP RVU
0.06
Office payment
$220.78
Facility payment
$220.78

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 78740 in a non-facility setting with national GPCI: (0.56 + 5.99 + 0.06) × $33.4009 ≈ $220.78. The same code in a facility setting pays about $220.78 because facility PE RVU (5.99) replaces office PE RVU.

What changes by locality

GPCI moves 78740 non-facility payment from $191.6 to $310.34 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 78740?

0.56. 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 78740 in 2026?

About $220.78 non-facility ($220.78 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 (0.56) and malpractice RVU stay fixed; only practice expense changes (5.99 office vs 5.99 facility). That is the entire office-vs-facility payment gap.