CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 91125 RVU and Medicare Payment (2026)
Anrct mano rct snsatn&balo — 2.7 work RVU, about $347.37 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.7
- PE RVU (non-facility)
- 7.53
- PE RVU (facility)
- 7.53
- MP RVU
- 0.17
- Office payment
- $347.37
- Facility payment
- $347.37
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 91125 in a non-facility setting with national GPCI: (2.7 + 7.53 + 0.17) × $33.4009 ≈ $347.37. The same code in a facility setting pays about $347.37 because facility PE RVU (7.53) replaces office PE RVU.
What changes by locality
GPCI moves 91125 non-facility payment from $309.15 to $465.82 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 91125?
2.7. 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 91125 in 2026?
About $347.37 non-facility ($347.37 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 (2.7) and malpractice RVU stay fixed; only practice expense changes (7.53 office vs 7.53 facility). That is the entire office-vs-facility payment gap.