CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 40843 RVU and Medicare Payment (2026)
Reconstruction of mouth — 12.47 work RVU, about $1,294.28 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 12.47
- PE RVU (non-facility)
- 23.96
- PE RVU (facility)
- 8.52
- MP RVU
- 2.32
- Office payment
- $1,294.28
- Facility payment
- $778.57
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 40843 in a non-facility setting with national GPCI: (12.47 + 23.96 + 2.32) × $33.4009 ≈ $1,294.28. The same code in a facility setting pays about $778.57 because facility PE RVU (8.52) replaces office PE RVU.
What changes by locality
GPCI moves 40843 non-facility payment from $1,143.86 to $1,657.87 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 40843?
12.47. 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 40843 in 2026?
About $1,294.28 non-facility ($778.57 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 (12.47) and malpractice RVU stay fixed; only practice expense changes (23.96 office vs 8.52 facility). That is the entire office-vs-facility payment gap.