CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 38794 RVU and Medicare Payment (2026)
Access thoracic lymph duct — 4.5 work RVU, about $258.52 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 4.5
- PE RVU (non-facility)
- 2.71
- PE RVU (facility)
- 2.71
- MP RVU
- 0.53
- Office payment
- $258.52
- Facility payment
- $258.52
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 38794 in a non-facility setting with national GPCI: (4.5 + 2.71 + 0.53) × $33.4009 ≈ $258.52. The same code in a facility setting pays about $258.52 because facility PE RVU (2.71) replaces office PE RVU.
What changes by locality
GPCI moves 38794 non-facility payment from $237.17 to $331.61 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 38794?
4.5. 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 38794 in 2026?
About $258.52 non-facility ($258.52 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 (4.5) and malpractice RVU stay fixed; only practice expense changes (2.71 office vs 2.71 facility). That is the entire office-vs-facility payment gap.