CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21040 RVU and Medicare Payment (2026)
Excise mandible lesion — 4.79 work RVU, about $479.97 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 4.79
- PE RVU (non-facility)
- 8.99
- PE RVU (facility)
- 4.73
- MP RVU
- 0.59
- Office payment
- $479.97
- Facility payment
- $337.68
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 21040 in a non-facility setting with national GPCI: (4.79 + 8.99 + 0.59) × $33.4009 ≈ $479.97. The same code in a facility setting pays about $337.68 because facility PE RVU (4.73) replaces office PE RVU.
What changes by locality
GPCI moves 21040 non-facility payment from $428.07 to $621.15 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 21040?
4.79. 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 21040 in 2026?
About $479.97 non-facility ($337.68 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 (4.79) and malpractice RVU stay fixed; only practice expense changes (8.99 office vs 4.73 facility). That is the entire office-vs-facility payment gap.