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QPP/APM

QPP vs Non-QPP Conversion Factor Calculator

Side-by-side conversion factor comparison that isolates QPP/APM status from CPT, setting, and locality.

For
Clinicians and administrators checking 2026 payment status
Inputs
CPT/HCPCS code and setting
Output
Non-QPP payment, QPP payment, payment delta

QPP and non-QPP comparison

Use the same CPT, locality, and setting to isolate the 2026 conversion factor difference.

Inputs
01
Setting
Results
02
QPP payment delta

0.49% difference for CPT 99214 in National Average.

$0.67
Non-QPP
$135.61
QPP
$136.28
Total RVU
4.06
Delta %
0.49%
Review
03
Conversion factor comparison
Same CPT RVU components and GPCI factors are multiplied by each 2026 conversion factor. Only the conversion factor changes between non-QPP and QPP calculations.
Assumptions
Locality
National: National Average
Setting
Office
Non-QPP CF
$33.4009
QPP CF
$33.5675
CMS provenance
Source file and formula trace
Source file

2026/rvu26b

Release date

2026-03-10

Field mapping

CPT or HCPCS code, Work RVU, Practice expense RVU, Malpractice RVU, GPCI locality, Conversion factor

QPP/APM comparison provenance for CPT 99214. The calculation uses CMS April 2026 RVU records, GPCI localities, and conversion factors. Verify official CMS and payer rules before billing or contract decisions.

  • CPT or HCPCS code: CMS PFS Relative Value Files RVU record and descriptor fields
  • Work RVU: CMS PFS Relative Value Files work RVU component
  • Practice expense RVU: CMS PFS Relative Value Files facility and non-facility PE RVU fields
  • Malpractice RVU: CMS PFS Relative Value Files malpractice RVU component
Professional use
Conversion factor only

This isolates QPP/APM status. It does not change CPT work RVU, setting, locality, documentation, or payer policy.

Next tool action
Core RVU calculatorCompare GPCI
APM participation check

Use QPP status only when the clinician or organization qualifies under CMS participation rules for the period being reviewed.

Open CMS participation lookup
CPT 99214 National Average: QPP $136.28, non-QPP $135.61, delta $0.67.

Related workflows

Use these tools when the current result needs payment, geography, compensation, or productivity context.

RVU CalculatorCore CPT payment calculator using 2026 CMS RVU and GPCI data.PaymentGPCI CalculatorCompare how geographic factors change Medicare payment across localities.GeographyCms 2026 DataOpen the related RVUinUSA workflow.Reference
CMS 2026 data source

Uses the CMS April 2026 Physician Fee Schedule RVU files, GPCI localities, and 2026 conversion factors. Estimates should be verified against official CMS files for billing decisions.

For calculator workflows, calculator inputs are processed in the browser. Contact, lead forms and PDF download forms are separate submissions.

What changes between QPP and non-QPP estimates?

The conversion factor changes. CPT RVU components, setting, and GPCI locality should stay fixed when comparing QPP and non-QPP payment.

Should I use QPP by default?

No. Use QPP only when the clinician or organization qualifies under CMS participation rules for the payment period being modeled.

Does this calculator change wRVU?

No. It compares payment after total RVU is calculated; it does not change the work RVU assigned to the CPT code.