CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 46040 RVU and Medicare Payment (2026)
I&d ischiorct&/perirct absc — 5.24 work RVU, about $630.27 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.24
- PE RVU (non-facility)
- 12.43
- PE RVU (facility)
- 6.58
- MP RVU
- 1.2
- Office payment
- $630.27
- Facility payment
- $434.88
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 46040 in a non-facility setting with national GPCI: (5.24 + 12.43 + 1.2) × $33.4009 ≈ $630.27. The same code in a facility setting pays about $434.88 because facility PE RVU (6.58) replaces office PE RVU.
What changes by locality
GPCI moves 46040 non-facility payment from $552.3 to $814.44 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 46040?
5.24. 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 46040 in 2026?
About $630.27 non-facility ($434.88 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 (5.24) and malpractice RVU stay fixed; only practice expense changes (12.43 office vs 6.58 facility). That is the entire office-vs-facility payment gap.