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

CPT 92201 RVU and Medicare Payment (2026)

Opscpy extnd rta draw uni/bi — 0.39 work RVU, about $25.05 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
0.39
PE RVU (non-facility)
0.34
PE RVU (facility)
0.14
MP RVU
0.02
Office payment
$25.05
Facility payment
$18.37

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 92201 in a non-facility setting with national GPCI: (0.39 + 0.34 + 0.02) × $33.4009 ≈ $25.05. The same code in a facility setting pays about $18.37 because facility PE RVU (0.14) replaces office PE RVU.

What changes by locality

GPCI moves 92201 non-facility payment from $23.13 to $32 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 92201?

0.39. 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 92201 in 2026?

About $25.05 non-facility ($18.37 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 (0.39) and malpractice RVU stay fixed; only practice expense changes (0.34 office vs 0.14 facility). That is the entire office-vs-facility payment gap.