CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 99452 RVU and Medicare Payment (2026)
Ntrprof ph1/ntrnet/ehr rfrl — 0.7 work RVU, about $37.07 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.7
- PE RVU (non-facility)
- 0.36
- PE RVU (facility)
- 0.18
- MP RVU
- 0.05
- Office payment
- $37.07
- Facility payment
- $31.06
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 99452 in a non-facility setting with national GPCI: (0.7 + 0.36 + 0.05) × $33.4009 ≈ $37.07. The same code in a facility setting pays about $31.06 because facility PE RVU (0.18) replaces office PE RVU.
What changes by locality
GPCI moves 99452 non-facility payment from $34.57 to $48.8 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 99452?
0.7. 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 99452 in 2026?
About $37.07 non-facility ($31.06 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 (0.7) and malpractice RVU stay fixed; only practice expense changes (0.36 office vs 0.18 facility). That is the entire office-vs-facility payment gap.