CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 42408 RVU and Medicare Payment (2026)
Excision of salivary cyst — 4.54 work RVU, about $570.15 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 4.54
- PE RVU (non-facility)
- 11.88
- PE RVU (facility)
- 4.52
- MP RVU
- 0.65
- Office payment
- $570.15
- Facility payment
- $324.32
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 42408 in a non-facility setting with national GPCI: (4.54 + 11.88 + 0.65) × $33.4009 ≈ $570.15. The same code in a facility setting pays about $324.32 because facility PE RVU (4.52) replaces office PE RVU.
What changes by locality
GPCI moves 42408 non-facility payment from $503.67 to $752.15 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 42408?
4.54. 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 42408 in 2026?
About $570.15 non-facility ($324.32 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 (4.54) and malpractice RVU stay fixed; only practice expense changes (11.88 office vs 4.52 facility). That is the entire office-vs-facility payment gap.