Medicare expected-payment calculator

Enter a code, ZIP and date of service to get the allowed amount, what Medicare pays, and the CMS file and row behind each figure.

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CPT / HCPCS code

5 don't apply to G2005

-26 Professional component. Code does not support a professional/technical split (PCTC indicator 0).
-TC Technical component. Code does not support a professional/technical split (PCTC indicator 0).
-50 Bilateral procedure. Bilateral adjustment does not apply to this code (indicator 0).
-62 Co-surgeons. Co-surgeon is not permitted for this code.
-66 Team surgery. Team surgery is not permitted for this code.

One modifier per line. Pricing -51? Use the MPPR calculator.

Service location

Leave blank for the national baseline.

Date of service

CMS release: 2026 D ·

Place of service

Office (non-facility) Facility

Billed by Physician (MD/DO)

Rendering provider

Payment answer

G2005

Proof packet

National PFS baseline

$217.11

in a doctor’s own office or clinic

Expected total to provider: $213.64

Medicare: $170.22 80%, after $3.47 sequestration
Patient: $43.42 20% coinsurance

Assumes the Part B deductible is met.

Date of service: Not supplied
Locality: National (Gpci 1.000)
Setting: Office (non-facility)
Participation: Participating provider
CMS release: Q4 2026

CMS RVU26DOctober 1 – December 31, 2026revision 2

( Work4.09 × 1.000 + Practice exp.2.16 × 1.000 + Malpractice0.25 × 1.000 ) × Conv. factor$33.4009 = $217.11

row 15,413

F Work RVU

4.09

G Non‑facility PE RVU

2.16

K MP RVU

0.25

Z Conversion factor

33.4009

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Patient responsibility

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