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CMS RVU Payment Reference Calculator

Estimate a CMS MPFS-style allowed amount from public RVU components, GPCIs, conversion factor, place of service, and units.

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Inputs

Your values stay on this device.

Results

Estimated Allowed Amount
Total Adjusted RVU2.3
Work Component1
Practice Expense Component1.2
Malpractice Component0.1

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Assumptions

  • This tool does not include CPT descriptions or official fee schedule rows.
  • The user is responsible for entering RVU components they are authorized to use.
  • Preset conversion factors are checked-in snapshots and can become stale.

Sensitivity preview

Work RVU -10%: Estimated Allowed Amount $73.48

Work RVU Current: Estimated Allowed Amount $76.82

Work RVU +10%: Estimated Allowed Amount $80.16

Formula: Estimated amount = [(work RVU x work GPCI) + (selected PE RVU x PE GPCI) + (MP RVU x MP GPCI)] x conversion factor x units.

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About this CMS RVU Payment Reference Calculator

CMS Physician Fee Schedule payment amounts are built from work, practice-expense, and malpractice RVU components adjusted by geographic practice cost indices and multiplied by a conversion factor. This tool keeps that public formula visible without reproducing CPT descriptions.

Who this calculator is for

  • Revenue cycle analysts checking RVU component math.
  • Billing managers documenting MPFS-style reimbursement assumptions.
  • Practice administrators comparing facility and non-facility planning scenarios.

When to use it

  • Convert public RVU components into a planning allowed amount.
  • Compare facility versus non-facility practice-expense assumptions.
  • Model geographic or conversion-factor changes before reviewing official fee schedule values.

How to use this calculator

  1. Enter an optional procedure code label only if you are licensed or otherwise permitted to use it.
  2. Enter public RVU component values from CMS or another source you are authorized to use.
  3. Choose a source-dated conversion factor preset or custom conversion factor.
  4. Enter GPCI values and units, then review the formula components.

Key assumptions

  • This tool does not include CPT descriptions or official fee schedule rows.
  • The user is responsible for entering RVU components they are authorized to use.
  • Preset conversion factors are checked-in snapshots and can become stale.
  • The calculation is local and deterministic.

Dataset sources

CMS Physician Fee Schedule documentation
Effective date
2026-03-04
Last reviewed
2026-05-05

This calculator does not provide CPT descriptions, coding advice, official payment amounts, or payer-specific reimbursement guidance.

Public CMS methodology reference. CPT codes and descriptions are not reproduced.

Accuracy and testing

Review formula sources, default test cases, assumptions, unit handling, rounding rules, and changelog for this calculator.

View accuracy page

How this calculator works

Non-facility payment = [(work RVU x work GPCI) + (non-facility PE RVU x PE GPCI) + (MP RVU x MP GPCI)] x conversion factor x units. Facility mode uses facility PE RVU instead of non-facility PE RVU.
Estimated amount = [(work RVU x work GPCI) + (selected PE RVU x PE GPCI) + (MP RVU x MP GPCI)] x conversion factor x units.

Inputs explained

RVU components

Work, practice-expense, and malpractice RVU values from public CMS files or another authorized source.

Place of service

Controls whether facility or non-facility practice-expense RVU is used.

GPCI values

Geographic practice cost indices applied to each RVU component.

Conversion factor

Source-dated CMS conversion factor preset or manually entered value.

Understanding your results

Estimated allowed amount is a formula-based planning result, not an official CMS payment determination. Compare against the official CMS look-up tool or payer remit before taking action.

Example scenarios

Formula check

A 1.00 work RVU, 1.20 non-facility PE RVU, 0.10 MP RVU, all GPCIs at 1.0, and a $33.4009 conversion factor returns about $76.82 for one unit.

Key Features

  • Instant Calculation
  • Private & Secure
  • Mobile Optimized

Things to Keep in Mind

This calculator does not determine coding, coverage, modifiers, status indicators, locality, sequestration, multiple-procedure reductions, assistant-at-surgery rules, payer contracts, or official Medicare payment.

Tips & Best Practices

  • Use the official CMS files or look-up tool to verify RVU components and locality-specific payment.
  • Avoid storing CPT descriptions unless you have the necessary license.
  • Run separate facility and non-facility scenarios when place of service can change payment.

Frequently Asked Questions

Does this include CPT descriptions?
No. CPT descriptions are not reproduced. The optional procedure code field is a label only and should be used only when you are authorized to use that code.
Is this an official Medicare payment amount?
No. It is a formula calculator for planning and checking math. Verify official results in CMS files, locality data, payer policy, and remittance records.
Are RVU values stored?
No. The calculation runs locally in your browser.