Roles & billing
Medicare Conversion Factor: 2026 Values and How It Works
By the NPI Portal editorial team Reviewed & updated Jul 10, 2026
The Medicare conversion factor (CF) is the dollar multiplier that turns relative value units into an actual payment. Every service under the Physician Fee Schedule is assigned RVUs; the conversion factor is what converts that abstract score into money. For 2026 there are, for the first time, two conversion factors: $33.5675 for qualifying alternative payment model participants (QPs) and $33.4009 for everyone else.
How the conversion factor is used
The Physician Fee Schedule payment formula is:
payment = total RVUs × GPCI adjustments × conversion factor
Each service’s total RVUs combine three components: physician work, practice expense, and malpractice, and each component is adjusted by a Geographic Practice Cost Index (GPCI) for the locality where the service is furnished. The conversion factor then scales the result into dollars. To see what a specific code pays under this formula, use the RVU calculator.
Because the CF multiplies everything, a change of a few percent moves payment for every service under the fee schedule at once. That is why the annual CF announcement gets so much attention.
Who sets it and why it changes
CMS sets the conversion factor each year in the Physician Fee Schedule final rule, published in the fall for the following calendar year. Two forces drive the year-to-year movement:
- Statutory updates. Congress fixes the baseline update in law. Under MACRA these were 0% for several years, and Congress has repeatedly passed one-off adjustments on top, including a one-year +2.50% increase for 2026.
- Budget neutrality. When CMS revalues RVUs, the law requires that overall spending stay roughly flat, so increases to some services are offset by adjusting the CF for all of them. This is how the CF can fall even in years with no statutory cut.
Why 2026 has two conversion factors
MACRA prescribed differential updates beginning in 2026: +0.75% for qualifying alternative payment model participants and +0.25% for everyone else. Applying two different updates to one 2025 conversion factor necessarily produces two 2026 values: $33.5675 for QPs and $33.4009 for non-QPs, and the gap will compound in future years as the differential updates repeat.
QP status is determined through the Quality Payment Program based on participation thresholds in Advanced APMs; it attaches to the clinician, not to individual claims.
Recent conversion factors
| Year | Conversion factor |
|---|---|
| 2021 | $34.8931 |
| 2022 | $34.6062 |
| 2023 | $33.8872 |
| 2024 | $32.7442 (Jan 1-Mar 8), then $33.2875 (Mar 9-Dec 31) |
| 2025 | $32.3465 |
| 2026 | $33.5675 (QPs) / $33.4009 (all others) |
The 2024 split-year values show the pattern of late congressional fixes: the year began at $32.7442, then the Consolidated Appropriations Act, 2024 raised the CF to $33.2875 for dates of service from March 9 onward. The 2025 value fell again when that temporary adjustment expired.
Note that anesthesia has its own separate national conversion factor, applied to base and time units rather than the RVU formula above.
Working out what a code pays
The CF alone tells you the multiplier, not the price. To price a service you need its RVUs, your locality’s GPCIs, and the applicable CF; the RVU calculator combines all three so you can see what a code pays without doing the arithmetic by hand. For the identifiers that appear alongside payment data, see what an NPI number is.
Conversion factor values on this page come from the CMS Physician Fee Schedule final rules and RVU files. NPI Portal is an independent tool built on public CMS data and is not affiliated with any government agency.