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

CPT 95813 RVU and Medicare Payment (2026)

Eeg extnd mntr 61-119 min — 1.63 work RVU, about $479.64 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
1.63
PE RVU (non-facility)
12.61
PE RVU (facility)
12.61
MP RVU
0.12
Office payment
$479.64
Facility payment
$479.64

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 95813 in a non-facility setting with national GPCI: (1.63 + 12.61 + 0.12) × $33.4009 ≈ $479.64. The same code in a facility setting pays about $479.64 because facility PE RVU (12.61) replaces office PE RVU.

What changes by locality

GPCI moves 95813 non-facility payment from $418.31 to $669.93 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 95813?

1.63. 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 95813 in 2026?

About $479.64 non-facility ($479.64 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 (1.63) and malpractice RVU stay fixed; only practice expense changes (12.61 office vs 12.61 facility). That is the entire office-vs-facility payment gap.