CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT G0138 RVU and Medicare Payment (2026)
Iv cipaglucosidase alfa-atga — 0.21 work RVU, about $196.4 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.21
- PE RVU (non-facility)
- 5.62
- PE RVU (facility)
- 5.62
- MP RVU
- 0.05
- Office payment
- $196.4
- Facility payment
- $196.4
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 G0138 in a non-facility setting with national GPCI: (0.21 + 5.62 + 0.05) × $33.4009 ≈ $196.4. The same code in a facility setting pays about $196.4 because facility PE RVU (5.62) replaces office PE RVU.
What changes by locality
GPCI moves G0138 non-facility payment from $169.12 to $279.36 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 G0138?
0.21. 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 G0138 in 2026?
About $196.4 non-facility ($196.4 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 (0.21) and malpractice RVU stay fixed; only practice expense changes (5.62 office vs 5.62 facility). That is the entire office-vs-facility payment gap.