CPT 55712 RVU Values & Medicare Payment 2026
Bx prst8 tprnl mri-us 1st
Code-level payment context
review the code record, calculate payment with fixed assumptions, compare locality or setting effects, and route into benchmark review when needed.
- Input
- CPT 55712, setting, participant status, and locality
- Source basis
- CMS 2026 CPT/HCPCS RVU components, typical setting, 2026 conversion factor assumption, GPCI locality examples, and related-code mapping.
- Result boundary
- The page does not validate code selection, payer-specific edits, modifier rules, or documentation support.
CPT 55712 is calculated with its CMS 2026 RVU components, the National Average GPCI locality, the non-facility practice expense setting, and the non-QPP conversion factor.
CPT 55712 setting and related-code comparison
Compare the same CPT under both PE settings, then review adjacent codes using National Average GPCI and the selected 2026 conversion factor.
| Setting | Work RVU | PE RVU | MP RVU | Total RVU | Payment |
|---|---|---|---|---|---|
| Non-facility | 3.10 | 14.66 | 0.41 | 18.17 | $606.89 |
| Facility | 3.10 | 1.22 | 0.41 | 4.73 | $157.99 |
| Related CPT | Descriptor | wRVU | Typical setting | National payment |
|---|---|---|---|---|
| CPT 55710 | Bx prst8 tprn us w/mri fus 1 | 3.81 | Non-facility | $652.32 |
| CPT 55711 | Bx prst8 trct mri-us 1st | 2.61 | Non-facility | $367.41 |
| CPT 55713 | Bx prst8 in-bore ct/mri bx 1 | 4.00 | Non-facility | $764.21 |
| CPT 55714 | Bx prst8 in-bore ct/mri 1 | 3.62 | Non-facility | $745.51 |
| CPT 99214 | Office o/p est mod 30 min | 1.92 | Non-facility | $135.61 |
CPT RVU and Medicare payment calculator
Search a CPT code, choose geography and participation status, then review work RVU, PE RVU, MP RVU, total RVU, and estimated Medicare payment. Use work RVU for productivity context and total RVU for Medicare payment estimates.
18.17 total RVU in National Average, National.
- Payment estimate: use total RVU and non-QPP $33.4009 for Medicare payment review.
- Productivity review: use work RVU separately; total RVU is not a physician productivity target.
- Before relying on it: confirm office / non-facility, National Average, and payer-specific billing rules.
Total RVU = work RVU x GPCI work + PE RVU x GPCI PE + MP RVU x GPCI MP. Payment = total RVU x selected 2026 conversion factor. Non-QPP uses $33.4009 and QPP uses $33.5675.
- CPT
- 55712
- Setting
- office / non-facility
- Conversion factor
- non-QPP $33.4009
- Work GPCI
- 1.000
- PE GPCI
- 1.000
- MP GPCI
- 1.000
Keep this CPT, setting, locality, and conversion factor fixed when moving into geography, contract, or benchmark review.
Payment by representative localities
| Locality | wRVU | Total RVU | Medicare Payment |
|---|---|---|---|
| National: National Average | 3.10 | 18.17 | $606.89 |
| California: San Francisco | 3.10 | 22.70 | $758.09 |
| California: Los Angeles | 3.10 | 21.03 | $702.42 |
| New York: Manhattan | 3.10 | 20.98 | $700.87 |
| New York: Rest of New York | 3.10 | 19.41 | $648.44 |
| Texas: Dallas | 3.10 | 18.08 | $603.92 |
| Texas: Houston | 3.10 | 18.25 | $609.44 |
| Florida: Miami | 3.10 | 19.40 | $647.91 |
CPT 55712 code profile
CMS 2026 Physician Fee Schedule inputs for this CPT/HCPCS code, including the site-of-service assumption used for the payment examples on this page.
Bx prst8 tprnl mri-us 1st
- Typical setting
- Office / non-facility
- Specialty mapping
- Nephrology
- Related codes
- 55710, 55711, 55713, 55714, 99214
RVU components are payment inputs, not clinical coding guidance. Confirm code selection, modifiers, payer policy, and documentation requirements through the official CMS source files or billing review. Locality-adjusted estimates should be interpreted with the selected setting, GPCI locality, and QPP status held constant.
CPT FAQ
Common RVU and payment questions for CPT 55712.
What is the wRVU for CPT 55712?
The imported CMS 2026 Physician Fee Schedule source files list 3.10 work RVU for CPT 55712.
What is the national payment estimate for CPT 55712?
Using national GPCI and the 2026 non-QPP conversion factor, the estimate is $606.89.
Does locality change the payment?
Yes. GPCI values adjust work, practice expense, and malpractice components by geography.