CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 96542 RVU and Medicare Payment (2026)
Chemotherapy injection — 0.75 work RVU, about $134.27 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.75
- PE RVU (non-facility)
- 3.21
- PE RVU (facility)
- 0.26
- MP RVU
- 0.06
- Office payment
- $134.27
- Facility payment
- $35.74
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 96542 in a non-facility setting with national GPCI: (0.75 + 3.21 + 0.06) × $33.4009 ≈ $134.27. The same code in a facility setting pays about $35.74 because facility PE RVU (0.26) replaces office PE RVU.
What changes by locality
GPCI moves 96542 non-facility payment from $118.18 to $183.49 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 96542?
0.75. 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 96542 in 2026?
About $134.27 non-facility ($35.74 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 (0.75) and malpractice RVU stay fixed; only practice expense changes (3.21 office vs 0.26 facility). That is the entire office-vs-facility payment gap.