CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 42305 RVU and Medicare Payment (2026)
Drainage of salivary gland — 6.15 work RVU, about $384.78 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.15
- PE RVU (non-facility)
- 4.47
- PE RVU (facility)
- 4.47
- MP RVU
- 0.9
- Office payment
- $384.78
- Facility payment
- $384.78
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 42305 in a non-facility setting with national GPCI: (6.15 + 4.47 + 0.9) × $33.4009 ≈ $384.78. The same code in a facility setting pays about $384.78 because facility PE RVU (4.47) replaces office PE RVU.
What changes by locality
GPCI moves 42305 non-facility payment from $349.15 to $483.69 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 42305?
6.15. 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 42305 in 2026?
About $384.78 non-facility ($384.78 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 (6.15) and malpractice RVU stay fixed; only practice expense changes (4.47 office vs 4.47 facility). That is the entire office-vs-facility payment gap.