CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 99215 RVU and Medicare Payment (2026)
Office o/p est hi 40 min — 2.8 work RVU, about $192.39 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.8
- PE RVU (non-facility)
- 2.75
- PE RVU (facility)
- 0.75
- MP RVU
- 0.21
- Office payment
- $192.39
- Facility payment
- $125.59
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 99215 in a non-facility setting with national GPCI: (2.8 + 2.75 + 0.21) × $33.4009 ≈ $192.39. The same code in a facility setting pays about $125.59 because facility PE RVU (0.75) replaces office PE RVU.
What changes by locality
GPCI moves 99215 non-facility payment from $176.04 to $241.97 across CMS localities — from Arkansas to Alaska. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Going deeper: in-depth CPT 99215 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 99215?
2.8. 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 99215 in 2026?
About $192.39 non-facility ($125.59 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 (2.8) and malpractice RVU stay fixed; only practice expense changes (2.75 office vs 0.75 facility). That is the entire office-vs-facility payment gap.