CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31

CPT 42415 RVU and Medicare Payment (2026)

Excise parotid gland/lesion — 16.73 work RVU, about $920.19 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
16.73
PE RVU (non-facility)
8.31
PE RVU (facility)
8.31
MP RVU
2.51
Office payment
$920.19
Facility payment
$920.19

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 42415 in a non-facility setting with national GPCI: (16.73 + 8.31 + 2.51) × $33.4009 ≈ $920.19. The same code in a facility setting pays about $920.19 because facility PE RVU (8.31) replaces office PE RVU.

What changes by locality

GPCI moves 42415 non-facility payment from $840.4 to $1,179.99 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 42415?

16.73. 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 42415 in 2026?

About $920.19 non-facility ($920.19 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 (16.73) and malpractice RVU stay fixed; only practice expense changes (8.31 office vs 8.31 facility). That is the entire office-vs-facility payment gap.