CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 40808 RVU and Medicare Payment (2026)
Biopsy of mouth lesion — 1.02 work RVU, about $168.01 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.02
- PE RVU (non-facility)
- 3.87
- PE RVU (facility)
- 1.31
- MP RVU
- 0.14
- Office payment
- $168.01
- Facility payment
- $82.5
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 40808 in a non-facility setting with national GPCI: (1.02 + 3.87 + 0.14) × $33.4009 ≈ $168.01. The same code in a facility setting pays about $82.5 because facility PE RVU (1.31) replaces office PE RVU.
What changes by locality
GPCI moves 40808 non-facility payment from $147.51 to $226.72 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 40808?
1.02. 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 40808 in 2026?
About $168.01 non-facility ($82.5 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 (1.02) and malpractice RVU stay fixed; only practice expense changes (3.87 office vs 1.31 facility). That is the entire office-vs-facility payment gap.