Work, practice, expense and liability relative value units (RVUs) are updated annually through the Centers for Medicare and Medicaid Services' Medicare Physician Fee Schedule (PFS) rulemaking. In response to the recently released 2026 Medicare PFS proposed rule, the ACC has developed a PFS calculator to allow clinicians and practice managers to estimate the potential impact of changes to their practices.

Of note, many services see impacts due to the broad policy proposals that would reduce most services by 2.5% to account for an efficiency adjustment and reduce the indirect cost payment formula for many services provided in hospitals. Those savings are then put back into the fee schedule through the conversion factor, so services not affected by those changes would increase. The tool includes new codes and/or values for PCI, lower extremity revascularization, left atrial appendage occlusion, and more.

Download the 2026 Medicare PFS Proposed Rule Calculator.

For more information about the regulatory process and timeline, access the ACC's PFS Roadmap. This resource provides a step-by-step look at the way the College reviews and addresses new values in the proposed PFS and how ACC staff consolidate input through internal channels to develop a formal policy position.