CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 38243 RVU and Medicare Payment (2026)
Transplj hematopoietic boost — 2.08 work RVU, about $101.54 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.08
- PE RVU (non-facility)
- 0.82
- PE RVU (facility)
- 0.82
- MP RVU
- 0.14
- Office payment
- $101.54
- Facility payment
- $101.54
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 38243 in a non-facility setting with national GPCI: (2.08 + 0.82 + 0.14) × $33.4009 ≈ $101.54. The same code in a facility setting pays about $101.54 because facility PE RVU (0.82) replaces office PE RVU.
What changes by locality
GPCI moves 38243 non-facility payment from $95.41 to $135.96 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 38243?
2.08. 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 38243 in 2026?
About $101.54 non-facility ($101.54 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 (2.08) and malpractice RVU stay fixed; only practice expense changes (0.82 office vs 0.82 facility). That is the entire office-vs-facility payment gap.