CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 99212 RVU and Medicare Payment (2026)
Office o/p est sf 10 min — 0.7 work RVU, about $59.45 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.7
- PE RVU (non-facility)
- 1.02
- PE RVU (facility)
- 0.17
- MP RVU
- 0.06
- Office payment
- $59.45
- Facility payment
- $31.06
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 99212 in a non-facility setting with national GPCI: (0.7 + 1.02 + 0.06) × $33.4009 ≈ $59.45. The same code in a facility setting pays about $31.06 because facility PE RVU (0.17) replaces office PE RVU.
What changes by locality
GPCI moves 99212 non-facility payment from $53.68 to $76.15 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
Going deeper: in-depth CPT 99212 RVU guide.
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 99212?
0.7. 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 99212 in 2026?
About $59.45 non-facility ($31.06 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 (0.7) and malpractice RVU stay fixed; only practice expense changes (1.02 office vs 0.17 facility). That is the entire office-vs-facility payment gap.