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Relative Value Units (RVUs) are the building blocks of Medicare physician payment. Every CPT code has three RVU components that reflect the resources required to perform the service.

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The three components

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Facility vs non-facility rates

PE RVUs have two rates:
  • Facility — Used when the service is performed in a hospital or ASC (the facility bears most overhead costs)
  • Non-facility — Used when the service is performed in a physician’s office (the practice bears overhead costs)
Non-facility PE RVUs are always higher because they include the cost of supplies and equipment that a facility would otherwise provide.

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Payment calculation

The Medicare Physician Fee Schedule (MPFS) calculates payment as:

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Example: CPT 99213 in Kansas (CCN 170001)

Payment = 2.223 × 32.35=∗∗32.35 = **71.91**

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The conversion factor

The conversion factor (CF) is a dollar amount updated annually by CMS. For 2026: $32.35. The CF translates RVUs into dollars. When CMS updates the CF, all MPFS payments change proportionally.

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RCI and RVUs

The L6 (Service) layer in RCI’s knowledge graph resolves RVU data for a given CPT code and calculates the GPCI-adjusted payment based on the facility’s location (L1) and care setting (L3).