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

CPT 78800 RVU and Medicare Payment (2026)

Rp loclzj tum 1 area 1 d img — 0.62 work RVU, about $231.8 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
0.62
PE RVU (non-facility)
6.22
PE RVU (facility)
6.22
MP RVU
0.1
Office payment
$231.8
Facility payment
$231.8

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 78800 in a non-facility setting with national GPCI: (0.62 + 6.22 + 0.1) × $33.4009 ≈ $231.8. The same code in a facility setting pays about $231.8 because facility PE RVU (6.22) replaces office PE RVU.

What changes by locality

GPCI moves 78800 non-facility payment from $200.89 to $324.36 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 78800?

0.62. 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 78800 in 2026?

About $231.8 non-facility ($231.8 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 (0.62) and malpractice RVU stay fixed; only practice expense changes (6.22 office vs 6.22 facility). That is the entire office-vs-facility payment gap.