CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 95971 RVU and Medicare Payment (2026)
Alys smpl sp/pn npgt w/prgrm — 0.78 work RVU, about $50.44 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.78
- PE RVU (non-facility)
- 0.66
- PE RVU (facility)
- 0.18
- MP RVU
- 0.07
- Office payment
- $50.44
- Facility payment
- $34.4
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 95971 in a non-facility setting with national GPCI: (0.78 + 0.66 + 0.07) × $33.4009 ≈ $50.44. The same code in a facility setting pays about $34.4 because facility PE RVU (0.18) replaces office PE RVU.
What changes by locality
GPCI moves 95971 non-facility payment from $46.19 to $63.84 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 95971?
0.78. 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 95971 in 2026?
About $50.44 non-facility ($34.4 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 (0.78) and malpractice RVU stay fixed; only practice expense changes (0.66 office vs 0.18 facility). That is the entire office-vs-facility payment gap.