CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21049 RVU and Medicare Payment (2026)
Excis uppr jaw cyst w/repair — 18.84 work RVU, about $1,021.07 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 18.84
- PE RVU (non-facility)
- 9.27
- PE RVU (facility)
- 9.27
- MP RVU
- 2.46
- Office payment
- $1,021.07
- Facility payment
- $1,021.07
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 21049 in a non-facility setting with national GPCI: (18.84 + 9.27 + 2.46) × $33.4009 ≈ $1,021.07. The same code in a facility setting pays about $1,021.07 because facility PE RVU (9.27) replaces office PE RVU.
What changes by locality
GPCI moves 21049 non-facility payment from $937.56 to $1,318.94 across CMS localities — from Arkansas to Alaska. 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 21049?
18.84. 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 21049 in 2026?
About $1,021.07 non-facility ($1,021.07 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 (18.84) and malpractice RVU stay fixed; only practice expense changes (9.27 office vs 9.27 facility). That is the entire office-vs-facility payment gap.