CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 99345 RVU and Medicare Payment (2026)
Home/res vst new high mdm 75 — 3.88 work RVU, about $210.09 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.88
- PE RVU (non-facility)
- 2.16
- PE RVU (facility)
- 2.16
- MP RVU
- 0.25
- Office payment
- $210.09
- Facility payment
- $210.09
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 99345 in a non-facility setting with national GPCI: (3.88 + 2.16 + 0.25) × $33.4009 ≈ $210.09. The same code in a facility setting pays about $210.09 because facility PE RVU (2.16) replaces office PE RVU.
What changes by locality
GPCI moves 99345 non-facility payment from $195.87 to $275.83 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 99345?
3.88. 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 99345 in 2026?
About $210.09 non-facility ($210.09 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 (3.88) and malpractice RVU stay fixed; only practice expense changes (2.16 office vs 2.16 facility). That is the entire office-vs-facility payment gap.