CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 38381 RVU and Medicare Payment (2026)
Thoracic duct procedure — 13.05 work RVU, about $771.56 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 13.05
- PE RVU (non-facility)
- 6.84
- PE RVU (facility)
- 6.84
- MP RVU
- 3.21
- Office payment
- $771.56
- Facility payment
- $771.56
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 38381 in a non-facility setting with national GPCI: (13.05 + 6.84 + 3.21) × $33.4009 ≈ $771.56. The same code in a facility setting pays about $771.56 because facility PE RVU (6.84) replaces office PE RVU.
What changes by locality
GPCI moves 38381 non-facility payment from $687.28 to $956.21 across CMS localities — from Nebraska 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 38381?
13.05. 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 38381 in 2026?
About $771.56 non-facility ($771.56 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 (13.05) and malpractice RVU stay fixed; only practice expense changes (6.84 office vs 6.84 facility). That is the entire office-vs-facility payment gap.