CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 95970 RVU and Medicare Payment (2026)
Alys npgt w/o prgrmg — 0.35 work RVU, about $19.71 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.35
- PE RVU (non-facility)
- 0.21
- PE RVU (facility)
- 0.1
- MP RVU
- 0.03
- Office payment
- $19.71
- Facility payment
- $16.03
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 95970 in a non-facility setting with national GPCI: (0.35 + 0.21 + 0.03) × $33.4009 ≈ $19.71. The same code in a facility setting pays about $16.03 because facility PE RVU (0.1) replaces office PE RVU.
What changes by locality
GPCI moves 95970 non-facility payment from $18.23 to $25.56 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 95970?
0.35. 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 95970 in 2026?
About $19.71 non-facility ($16.03 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 (0.35) and malpractice RVU stay fixed; only practice expense changes (0.21 office vs 0.1 facility). That is the entire office-vs-facility payment gap.