# CPT 59426

> The national PFS baseline is $1,055.47 for CPT 59426 in the Office (non-facility) setting and $718.45 in a facility under the Q4 2026 Physician Fee Schedule, effective October 2026. These are the national allowed amounts before locality (GPCI) adjustment; sequestration is excluded. Across payment localities, the office amount is $926.88–$1,286.73 and the facility amount is $619.33–$932.10. This amount has been unchanged since Q1 2026, when it increased 5.1%.

## Selected release

- Release: Q4 2026 (2026 D)
- Effective: October 1 – December 31, 2026
- Status indicator: A
- Office (non-facility) national allowed amount: $1055.47
- Facility national allowed amount: $718.45
- Sequestration: not applied

## RVUs and formula

- Work RVU: 14.30
- Office (non-facility) practice expense RVU: 13.20
- Facility practice expense RVU: 3.11
- Malpractice RVU: 4.10
- 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: 6
- Modifier-allowed pair count: 46
- MUE units per patient per date of service: 1
- Complete list: https://localishealth.com/cpt/59426/ncci-edits.txt

## Source and citation

- Source: Physician relative value file (Q4 2026)
- CMS file: https://www.cms.gov/files/zip/rvu26d-updated-08-26-2026.zip
- Parsed file: PPRRVU2026_Oct_nonQPP.csv, row 6,661
- Canonical page: https://localishealth.com/cpt/59426
- Release-specific citation URL: https://localishealth.com/cpt/59426/2026/D
- Last significant update: 2026-09-01T06:33:29+00:00