CPT code 99157 (Mod sed other phys/qhp ea) carries 1.25 work RVUs under the CMS 2026 Medicare Physician Fee Schedule. Total RVUs are 1.62 in a non-facility setting and 1.62 in a facility setting, which at the 2026 conversion factor of $33.40 works out to $54.11 and $54.11 respectively.
| Component | RVUs | What it covers |
|---|---|---|
| Work RVU | 1.25 | Physician time, skill, effort, and stress. |
| Practice expense RVU (non-facility) | 0.23 | Office overhead, staff, supplies. |
| Practice expense RVU (facility) | 0.0 | Overhead when performed in a hospital. |
| Malpractice RVU | 0.14 | Professional liability cost. |
| Total RVU (non-facility) | 1.62 | Work + non-facility PE + malpractice. |
| Total RVU (facility) | 1.62 | Work + facility PE + malpractice. |
Medicare multiplies total RVUs by the annual conversion factor. For CPT 99157 in 2026:
| Setting | Total RVU | Conversion factor | National payment |
|---|---|---|---|
| Non-facility | 1.62 | $33.40 | $54.11 |
| Facility | 1.62 | $33.40 | $54.11 |
These are national amounts. Actual payment is adjusted by the Geographic Practice Cost Index for your locality — check yours with the GPCI lookup.
Codes in the same CMS family, with their work RVU values.
CPT 99157 is assigned 1.25 work RVUs in the CMS 2026 Medicare Physician Fee Schedule.
At the 2026 national conversion factor of $33.40, CPT 99157 pays approximately $54.11 in a non-facility setting and $54.11 in a facility setting before geographic adjustment.
Add-on code — global period is bundled with the primary procedure.