CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 38531 RVU and Medicare Payment (2026)
Open bx/exc inguinofem nodes — 6.57 work RVU, about $432.54 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.57
- PE RVU (non-facility)
- 4.75
- PE RVU (facility)
- 4.75
- MP RVU
- 1.63
- Office payment
- $432.54
- Facility payment
- $432.54
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 38531 in a non-facility setting with national GPCI: (6.57 + 4.75 + 1.63) × $33.4009 ≈ $432.54. The same code in a facility setting pays about $432.54 because facility PE RVU (4.75) replaces office PE RVU.
What changes by locality
GPCI moves 38531 non-facility payment from $383.77 to $528.13 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 38531?
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 38531 in 2026?
About $432.54 non-facility ($432.54 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 (4.75 office vs 4.75 facility). That is the entire office-vs-facility payment gap.