CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT G0318 RVU and Medicare Payment (2026)
Prolong home eval add 15m — 0.61 work RVU, about $34.07 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.61
- PE RVU (non-facility)
- 0.36
- PE RVU (facility)
- 0.16
- MP RVU
- 0.05
- Office payment
- $34.07
- Facility payment
- $27.39
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 G0318 in a non-facility setting with national GPCI: (0.61 + 0.36 + 0.05) × $33.4009 ≈ $34.07. The same code in a facility setting pays about $27.39 because facility PE RVU (0.16) replaces office PE RVU.
What changes by locality
GPCI moves G0318 non-facility payment from $31.56 to $44.29 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 G0318?
0.61. 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 G0318 in 2026?
About $34.07 non-facility ($27.39 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 (0.61) and malpractice RVU stay fixed; only practice expense changes (0.36 office vs 0.16 facility). That is the entire office-vs-facility payment gap.