CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 40720 RVU and Medicare Payment (2026)
Repair cleft lip/nasal — 14.35 work RVU, about $922.53 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 14.35
- PE RVU (non-facility)
- 10.6
- PE RVU (facility)
- 10.6
- MP RVU
- 2.67
- Office payment
- $922.53
- Facility payment
- $922.53
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 40720 in a non-facility setting with national GPCI: (14.35 + 10.6 + 2.67) × $33.4009 ≈ $922.53. The same code in a facility setting pays about $922.53 because facility PE RVU (10.6) replaces office PE RVU.
What changes by locality
GPCI moves 40720 non-facility payment from $829.36 to $1,145.16 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 40720?
14.35. 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 40720 in 2026?
About $922.53 non-facility ($922.53 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 (14.35) and malpractice RVU stay fixed; only practice expense changes (10.6 office vs 10.6 facility). That is the entire office-vs-facility payment gap.