CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 67938 RVU and Medicare Payment (2026)
Remove eyelid foreign body — 1.35 work RVU, about $252.18 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.35
- PE RVU (non-facility)
- 6.14
- PE RVU (facility)
- 1.59
- MP RVU
- 0.06
- Office payment
- $252.18
- Facility payment
- $100.2
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 67938 in a non-facility setting with national GPCI: (1.35 + 6.14 + 0.06) × $33.4009 ≈ $252.18. The same code in a facility setting pays about $100.2 because facility PE RVU (1.59) replaces office PE RVU.
What changes by locality
GPCI moves 67938 non-facility payment from $222.29 to $346.85 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 67938?
1.35. 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 67938 in 2026?
About $252.18 non-facility ($100.2 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 (1.35) and malpractice RVU stay fixed; only practice expense changes (6.14 office vs 1.59 facility). That is the entire office-vs-facility payment gap.