CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21025 RVU and Medicare Payment (2026)
Excision of bone lower jaw — 9.78 work RVU, about $840.03 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.78
- PE RVU (non-facility)
- 14.06
- PE RVU (facility)
- 7.28
- MP RVU
- 1.31
- Office payment
- $840.03
- Facility payment
- $613.57
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 21025 in a non-facility setting with national GPCI: (9.78 + 14.06 + 1.31) × $33.4009 ≈ $840.03. The same code in a facility setting pays about $613.57 because facility PE RVU (7.28) replaces office PE RVU.
What changes by locality
GPCI moves 21025 non-facility payment from $752.6 to $1,063.23 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 21025?
9.78. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 21025 in 2026?
About $840.03 non-facility ($613.57 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (9.78) and malpractice RVU stay fixed; only practice expense changes (14.06 office vs 7.28 facility). That is the entire office-vs-facility payment gap.