CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 95060 RVU and Medicare Payment (2026)
Oph mucous membrane tests — 0 work RVU, about $40.75 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0
- PE RVU (non-facility)
- 1.21
- PE RVU (facility)
- 1.21
- MP RVU
- 0.01
- Office payment
- $40.75
- Facility payment
- $40.75
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 95060 in a non-facility setting with national GPCI: (0 + 1.21 + 0.01) × $33.4009 ≈ $40.75. The same code in a facility setting pays about $40.75 because facility PE RVU (1.21) replaces office PE RVU.
What changes by locality
GPCI moves 95060 non-facility payment from $34.89 to $58.46 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 95060?
0. 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 95060 in 2026?
About $40.75 non-facility ($40.75 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) and malpractice RVU stay fixed; only practice expense changes (1.21 office vs 1.21 facility). That is the entire office-vs-facility payment gap.