# CPT 53865

> The national PFS baseline is $3,086.58 for CPT 53865 in the office (non-facility) setting and $145.63 in a facility under the Q3 2026 Physician Fee Schedule, effective July 2026. These are the national allowed amounts before locality (GPCI) adjustment; sequestration is excluded. Across payment localities, the office amount is $2,661.11–$4,405.55 and the facility amount is $134.84–$192.28. This price has been unchanged since Q1 2026, when it increased 8.5%.

## Selected release

- Release: Q3 2026 (2026 C)
- Effective: July 1 – September 30, 2026
- Status indicator: A
- Office (non-facility) national allowed amount: $3086.58
- Facility national allowed amount: $145.63
- Sequestration: not applied

## RVUs and formula

- Work RVU: 3.02
- Office (non-facility) practice expense RVU: 89.00
- Facility practice expense RVU: 0.95
- Malpractice RVU: 0.39
- Conversion factor: 33.4009
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## NCCI edits

- Never-billable pair count: 148
- Modifier-allowed pair count: 137
- MUE units per patient per date of service: not published
- Complete list: https://localishealth.com/cpt/53865/ncci-edits.txt

## Source and citation

- Source: Physician relative value file (Q3 2026)
- CMS file: https://www.cms.gov/files/zip/rvu26c-updated-06-30-2026.zip
- Parsed file: PPRRVU2026_Jul_nonQPP.csv, row 6,172
- Canonical page: https://localishealth.com/cpt/53865
- Release-specific citation URL: https://localishealth.com/cpt/53865/2026/C
- Last significant update: 2026-08-11T00:15:57+00:00