CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 68040 RVU and Medicare Payment (2026)
Treatment of eyelid lesions — 0.83 work RVU, about $61.79 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.83
- PE RVU (non-facility)
- 0.98
- PE RVU (facility)
- 0.32
- MP RVU
- 0.04
- Office payment
- $61.79
- Facility payment
- $39.75
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 68040 in a non-facility setting with national GPCI: (0.83 + 0.98 + 0.04) × $33.4009 ≈ $61.79. The same code in a facility setting pays about $39.75 because facility PE RVU (0.32) replaces office PE RVU.
What changes by locality
GPCI moves 68040 non-facility payment from $56.53 to $78.69 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 68040?
0.83. 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 68040 in 2026?
About $61.79 non-facility ($39.75 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 (0.83) and malpractice RVU stay fixed; only practice expense changes (0.98 office vs 0.32 facility). That is the entire office-vs-facility payment gap.