CMS has released the 2026 Relative Value Units (RVUs), and these updates will have significant implications for allergists nationwide. RVUs, which form the backbone of Medicare reimbursement calculations, play a critical role in determining physician compensation and practice revenue. Understanding the changes from 2025 RVUs can help you estimate the impact on your practice – and your compensation – in 2026.
What are RVUs and why do they matter?
RVUs attempt to quantify the value of medical services provided by physicians. They incorporate factors such as physician work, practice expenses (PE), and malpractice insurance costs. These RVUs are converted into Medicare payment amounts through the application of a conversion factor (among other things). For 2026, CMS will implement two conversion factors: $33.5675 for Qualifying Alternative Payment Model (APM) participants (QPs) and $33.4009 for non-QPs. These conversion factors represent increases of 3.77% and 3.26%, respectively, over the 2025 conversion factor.
For allergists, RVUs directly impact Medicare reimbursement rates for common services, including allergy testing, immunotherapy and asthma management. RVUs also influence private payer contracts, as many insurers base their reimbursement rates on Medicare’s fee schedule. Thus, changes to RVUs can have a ripple effect across both public and private reimbursement systems, making them a critical focus for allergists and practice managers.
For employed allergists, work RVUs (wRVUs) often determine your productivity-based pay. Many employment contracts include a base salary with a productivity incentive tied to the number of wRVUs generated. Some academic centers use wRVUs to calculate physician productivity metrics, although they don’t impact compensation. In many cases, understanding how wRVUs will change in 2026 can help you understand the impact on your compensation.
Practice expense impact on RVUs
In the 2026 final rule, CMS finalized a dramatic change to practice expense methodology resulting in a considerable RVU and payment shift away from facility-based physicians and toward office-based physicians. CMS established two PE RVUs: one for services that are furnished in a facility setting (e.g., hospital) and one for services furnished in a non-facility setting (e.g., physician’s office). Specifically, beginning in 2026, CMS will reduce the portion of the facility PE RVUs allocated based on work RVUs to half the amount allocated to non-facility PE RVUs. The Advocacy Council developed a spreadsheet that compares the 2025 Total Non-Facility RVUs and Total Facility RVUs to those finalized for 2026.
For a complete list of 2026 RVUs and wRVUs, as well as RVUs/wRVUs for common allergy codes, view our resources below.
Key 2026 RVU resources for allergists
- 2026 vs. 2025 RVUs and national payment amounts for allergy/immunology (Download)
- 2026 vs. 2025 facility and non-facility RVUs for common allergy/immunology CPT codes (Download)
- 2026 RVUs for all CPT codes (Download)
To learn more about RVUs and why they’re important for both employed allergists and practice owners, check out our RVU toolkit. You can also read the Advocacy Council’s analysis of the 2026 Medicare Physician Fee Schedule Final Rule for more information.
