# CPT 42890

> The national PFS baseline was $1,466.56 for CPT 42890 in the office (non-facility) setting and $1,466.56 in a facility under the Q4 2021 Physician Fee Schedule, effective October 2021. These are the national allowed amounts before locality (GPCI) adjustment; sequestration is excluded. Across payment localities, both settings' amount is $1,308.85–$1,847.82. This amount has been unchanged since Q1 2021, when it decreased 0.4%.

## Selected release

- Release: Q4 2021 (2021 D)
- Effective: October 1 – December 31, 2021
- Status indicator: A
- Office (non-facility) national allowed amount: $1466.56
- Facility national allowed amount: $1466.56
- Sequestration: not applied

## RVUs and formula

- Work RVU: 19.13
- Office (non-facility) practice expense RVU: 20.24
- Facility practice expense RVU: 20.24
- Malpractice RVU: 2.66
- Conversion factor: 34.8931
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q4 2021)
- CMS file: https://www.cms.gov/files/zip/rvu21d.zip
- Parsed file: PPRRVU21_OCT.csv, row 9,584
- Canonical page: https://localishealth.com/cpt/42890/2021/A
- Release-specific citation URL: https://localishealth.com/cpt/42890/2021/D
- Last significant update: 2026-08-04T03:10:59+00:00