CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 99349 RVU and Medicare Payment (2026)
Home/res vst est mod mdm 40 — 2.44 work RVU, about $132.27 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.44
- PE RVU (non-facility)
- 1.36
- PE RVU (facility)
- 1.36
- MP RVU
- 0.16
- Office payment
- $132.27
- Facility payment
- $132.27
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 99349 in a non-facility setting with national GPCI: (2.44 + 1.36 + 0.16) × $33.4009 ≈ $132.27. The same code in a facility setting pays about $132.27 because facility PE RVU (1.36) replaces office PE RVU.
What changes by locality
GPCI moves 99349 non-facility payment from $123.27 to $173.57 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 99349?
2.44. 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 99349 in 2026?
About $132.27 non-facility ($132.27 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 (2.44) and malpractice RVU stay fixed; only practice expense changes (1.36 office vs 1.36 facility). That is the entire office-vs-facility payment gap.