CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 31225 RVU and Medicare Payment (2026)
Removal of upper jaw — 26.03 work RVU, about $1,577.52 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 26.03
- PE RVU (non-facility)
- 17.4
- PE RVU (facility)
- 17.4
- MP RVU
- 3.8
- Office payment
- $1,577.52
- Facility payment
- $1,577.52
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 31225 in a non-facility setting with national GPCI: (26.03 + 17.4 + 3.8) × $33.4009 ≈ $1,577.52. The same code in a facility setting pays about $1,577.52 because facility PE RVU (17.4) replaces office PE RVU.
What changes by locality
GPCI moves 31225 non-facility payment from $1,434.02 to $1,993.03 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 31225?
26.03. 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 31225 in 2026?
About $1,577.52 non-facility ($1,577.52 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 (26.03) and malpractice RVU stay fixed; only practice expense changes (17.4 office vs 17.4 facility). That is the entire office-vs-facility payment gap.