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

CPT 94012 RVU and Medicare Payment (2026)

Spirmtry w/brnchdil inf-2 yr — 2.78 work RVU, about $117.24 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
2.78
PE RVU (non-facility)
0.56
PE RVU (facility)
0.56
MP RVU
0.17
Office payment
$117.24
Facility payment
$117.24

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 94012 in a non-facility setting with national GPCI: (2.78 + 0.56 + 0.17) × $33.4009 ≈ $117.24. The same code in a facility setting pays about $117.24 because facility PE RVU (0.56) replaces office PE RVU.

What changes by locality

GPCI moves 94012 non-facility payment from $111.85 to $162.33 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 94012?

2.78. 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 94012 in 2026?

About $117.24 non-facility ($117.24 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 (2.78) and malpractice RVU stay fixed; only practice expense changes (0.56 office vs 0.56 facility). That is the entire office-vs-facility payment gap.