CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 94003 RVU and Medicare Payment (2026)
Vent mgmt inpat subq day — 1.37 work RVU, about $59.12 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.37
- PE RVU (non-facility)
- 0.28
- PE RVU (facility)
- 0.28
- MP RVU
- 0.12
- Office payment
- $59.12
- Facility payment
- $59.12
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 94003 in a non-facility setting with national GPCI: (1.37 + 0.28 + 0.12) × $33.4009 ≈ $59.12. The same code in a facility setting pays about $59.12 because facility PE RVU (0.28) replaces office PE RVU.
What changes by locality
GPCI moves 94003 non-facility payment from $55.86 to $80.81 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 94003?
1.37. 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 94003 in 2026?
About $59.12 non-facility ($59.12 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 (1.37) and malpractice RVU stay fixed; only practice expense changes (0.28 office vs 0.28 facility). That is the entire office-vs-facility payment gap.