CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 42892 RVU and Medicare Payment (2026)
Revision of pharyngeal walls — 25.38 work RVU, about $1,641.32 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 25.38
- PE RVU (non-facility)
- 20.06
- PE RVU (facility)
- 20.06
- MP RVU
- 3.7
- Office payment
- $1,641.32
- Facility payment
- $1,641.32
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 42892 in a non-facility setting with national GPCI: (25.38 + 20.06 + 3.7) × $33.4009 ≈ $1,641.32. The same code in a facility setting pays about $1,641.32 because facility PE RVU (20.06) replaces office PE RVU.
What changes by locality
GPCI moves 42892 non-facility payment from $1,486.91 to $2,053.24 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 42892?
25.38. 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 42892 in 2026?
About $1,641.32 non-facility ($1,641.32 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 (25.38) and malpractice RVU stay fixed; only practice expense changes (20.06 office vs 20.06 facility). That is the entire office-vs-facility payment gap.