CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 90791 RVU and Medicare Payment (2026)
Psych diagnostic evaluation — 3.84 work RVU, about $173.35 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.84
- PE RVU (non-facility)
- 1.33
- PE RVU (facility)
- 0.25
- MP RVU
- 0.02
- Office payment
- $173.35
- Facility payment
- $137.28
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 90791 in a non-facility setting with national GPCI: (3.84 + 1.33 + 0.02) × $33.4009 ≈ $173.35. The same code in a facility setting pays about $137.28 because facility PE RVU (0.25) replaces office PE RVU.
What changes by locality
GPCI moves 90791 non-facility payment from $166.76 to $240.07 across CMS localities — from Arkansas to Alaska. 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 90791?
3.84. 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 90791 in 2026?
About $173.35 non-facility ($137.28 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 (3.84) and malpractice RVU stay fixed; only practice expense changes (1.33 office vs 0.25 facility). That is the entire office-vs-facility payment gap.