CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 40530 RVU and Medicare Payment (2026)
Partial removal of lip — 5.4 work RVU, about $565.81 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.4
- PE RVU (non-facility)
- 10.68
- PE RVU (facility)
- 4.73
- MP RVU
- 0.86
- Office payment
- $565.81
- Facility payment
- $367.08
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 40530 in a non-facility setting with national GPCI: (5.4 + 10.68 + 0.86) × $33.4009 ≈ $565.81. The same code in a facility setting pays about $367.08 because facility PE RVU (4.73) replaces office PE RVU.
What changes by locality
GPCI moves 40530 non-facility payment from $501.58 to $729.99 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 40530?
5.4. 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 40530 in 2026?
About $565.81 non-facility ($367.08 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 (5.4) and malpractice RVU stay fixed; only practice expense changes (10.68 office vs 4.73 facility). That is the entire office-vs-facility payment gap.