CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 90472 RVU and Medicare Payment (2026)
Immunization admin each add — 0.15 work RVU, about $16.03 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.15
- PE RVU (non-facility)
- 0.32
- PE RVU (facility)
- 0.32
- MP RVU
- 0.01
- Office payment
- $16.03
- Facility payment
- $16.03
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 90472 in a non-facility setting with national GPCI: (0.15 + 0.32 + 0.01) × $33.4009 ≈ $16.03. The same code in a facility setting pays about $16.03 because facility PE RVU (0.32) replaces office PE RVU.
What changes by locality
GPCI moves 90472 non-facility payment from $14.36 to $21.15 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 90472?
0.15. 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 90472 in 2026?
About $16.03 non-facility ($16.03 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 (0.15) and malpractice RVU stay fixed; only practice expense changes (0.32 office vs 0.32 facility). That is the entire office-vs-facility payment gap.