CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 99480 RVU and Medicare Payment (2026)
Sbsq ic inf pbw 2,501-5,000 — 2.4 work RVU, about $101.2 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.4
- PE RVU (non-facility)
- 0.48
- PE RVU (facility)
- 0.48
- MP RVU
- 0.15
- Office payment
- $101.2
- Facility payment
- $101.2
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 99480 in a non-facility setting with national GPCI: (2.4 + 0.48 + 0.15) × $33.4009 ≈ $101.2. The same code in a facility setting pays about $101.2 because facility PE RVU (0.48) replaces office PE RVU.
What changes by locality
GPCI moves 99480 non-facility payment from $96.51 to $140.08 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 99480?
2.4. 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 99480 in 2026?
About $101.2 non-facility ($101.2 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 (2.4) and malpractice RVU stay fixed; only practice expense changes (0.48 office vs 0.48 facility). That is the entire office-vs-facility payment gap.