CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 26116 RVU and Medicare Payment (2026)
Exc hand tum deep < 1.5 cm — 6.57 work RVU, about $494 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.57
- PE RVU (non-facility)
- 6.97
- PE RVU (facility)
- 6.97
- MP RVU
- 1.25
- Office payment
- $494
- Facility payment
- $494
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 26116 in a non-facility setting with national GPCI: (6.57 + 6.97 + 1.25) × $33.4009 ≈ $494. The same code in a facility setting pays about $494 because facility PE RVU (6.97) replaces office PE RVU.
What changes by locality
GPCI moves 26116 non-facility payment from $440.92 to $601.67 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 26116?
6.57. 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 26116 in 2026?
About $494 non-facility ($494 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 (6.57) and malpractice RVU stay fixed; only practice expense changes (6.97 office vs 6.97 facility). That is the entire office-vs-facility payment gap.