CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 99422 RVU and Medicare Payment (2026)
Ol dig e/m svc 11-20 min — 0.5 work RVU, about $30.73 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.5
- PE RVU (non-facility)
- 0.38
- PE RVU (facility)
- 0.13
- MP RVU
- 0.04
- Office payment
- $30.73
- Facility payment
- $22.38
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 99422 in a non-facility setting with national GPCI: (0.5 + 0.38 + 0.04) × $33.4009 ≈ $30.73. The same code in a facility setting pays about $22.38 because facility PE RVU (0.13) replaces office PE RVU.
What changes by locality
GPCI moves 99422 non-facility payment from $28.29 to $39.3 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 99422?
0.5. 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 99422 in 2026?
About $30.73 non-facility ($22.38 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 (0.5) and malpractice RVU stay fixed; only practice expense changes (0.38 office vs 0.13 facility). That is the entire office-vs-facility payment gap.