CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 41016 RVU and Medicare Payment (2026)
Drainage of mouth lesion — 4.09 work RVU, about $483.65 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 4.09
- PE RVU (non-facility)
- 9.83
- PE RVU (facility)
- 5.09
- MP RVU
- 0.56
- Office payment
- $483.65
- Facility payment
- $325.32
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 41016 in a non-facility setting with national GPCI: (4.09 + 9.83 + 0.56) × $33.4009 ≈ $483.65. The same code in a facility setting pays about $325.32 because facility PE RVU (5.09) replaces office PE RVU.
What changes by locality
GPCI moves 41016 non-facility payment from $428.28 to $635.12 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 41016?
4.09. 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 41016 in 2026?
About $483.65 non-facility ($325.32 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 (4.09) and malpractice RVU stay fixed; only practice expense changes (9.83 office vs 5.09 facility). That is the entire office-vs-facility payment gap.