CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 99310 RVU and Medicare Payment (2026)
Sbsq nf care high mdm 45 — 2.8 work RVU, about $163.33 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.8
- PE RVU (non-facility)
- 1.88
- PE RVU (facility)
- 1.19
- MP RVU
- 0.21
- Office payment
- $163.33
- Facility payment
- $140.28
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 99310 in a non-facility setting with national GPCI: (2.8 + 1.88 + 0.21) × $33.4009 ≈ $163.33. The same code in a facility setting pays about $140.28 because facility PE RVU (1.19) replaces office PE RVU.
What changes by locality
GPCI moves 99310 non-facility payment from $151.07 to $211.02 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 99310?
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 99310 in 2026?
About $163.33 non-facility ($140.28 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 (1.88 office vs 1.19 facility). That is the entire office-vs-facility payment gap.