CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21338 RVU and Medicare Payment (2026)
Open nasoethmoid fx w/o fixj — 6.7 work RVU, about $626.93 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.7
- PE RVU (non-facility)
- 11.08
- PE RVU (facility)
- 11.08
- MP RVU
- 0.99
- Office payment
- $626.93
- Facility payment
- $626.93
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 21338 in a non-facility setting with national GPCI: (6.7 + 11.08 + 0.99) × $33.4009 ≈ $626.93. The same code in a facility setting pays about $626.93 because facility PE RVU (11.08) replaces office PE RVU.
What changes by locality
GPCI moves 21338 non-facility payment from $558.72 to $799.78 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 21338?
6.7. 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 21338 in 2026?
About $626.93 non-facility ($626.93 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 (6.7) and malpractice RVU stay fixed; only practice expense changes (11.08 office vs 11.08 facility). That is the entire office-vs-facility payment gap.