CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 90961 RVU and Medicare Payment (2026)
Esrd srv 2-3 vsts p mo 20+ — 5.52 work RVU, about $310.63 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.52
- PE RVU (non-facility)
- 3.42
- PE RVU (facility)
- 3.42
- MP RVU
- 0.36
- Office payment
- $310.63
- Facility payment
- $310.63
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 90961 in a non-facility setting with national GPCI: (5.52 + 3.42 + 0.36) × $33.4009 ≈ $310.63. The same code in a facility setting pays about $310.63 because facility PE RVU (3.42) replaces office PE RVU.
What changes by locality
GPCI moves 90961 non-facility payment from $288.69 to $404.84 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 90961?
5.52. 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 90961 in 2026?
About $310.63 non-facility ($310.63 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 (5.52) and malpractice RVU stay fixed; only practice expense changes (3.42 office vs 3.42 facility). That is the entire office-vs-facility payment gap.