CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 40654 RVU and Medicare Payment (2026)
Rpr lip fth>1half ver ht/cpx — 5.34 work RVU, about $616.58 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.34
- PE RVU (non-facility)
- 12.26
- PE RVU (facility)
- 5.63
- MP RVU
- 0.86
- Office payment
- $616.58
- Facility payment
- $395.13
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 40654 in a non-facility setting with national GPCI: (5.34 + 12.26 + 0.86) × $33.4009 ≈ $616.58. The same code in a facility setting pays about $395.13 because facility PE RVU (5.63) replaces office PE RVU.
What changes by locality
GPCI moves 40654 non-facility payment from $544.91 to $803.87 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 40654?
5.34. 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 40654 in 2026?
About $616.58 non-facility ($395.13 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 (5.34) and malpractice RVU stay fixed; only practice expense changes (12.26 office vs 5.63 facility). That is the entire office-vs-facility payment gap.