CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 42182 RVU and Medicare Payment (2026)
Repair palate — 3.77 work RVU, about $329 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.77
- PE RVU (non-facility)
- 5.54
- PE RVU (facility)
- 2.51
- MP RVU
- 0.54
- Office payment
- $329
- Facility payment
- $227.79
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 42182 in a non-facility setting with national GPCI: (3.77 + 5.54 + 0.54) × $33.4009 ≈ $329. The same code in a facility setting pays about $227.79 because facility PE RVU (2.51) replaces office PE RVU.
What changes by locality
GPCI moves 42182 non-facility payment from $294.16 to $416.27 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 42182?
3.77. 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 42182 in 2026?
About $329 non-facility ($227.79 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 (3.77) and malpractice RVU stay fixed; only practice expense changes (5.54 office vs 2.51 facility). That is the entire office-vs-facility payment gap.