CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43112 RVU and Medicare Payment (2026)
Esphg tot w/thrcm — 60.45 work RVU, about $3,198.8 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 60.45
- PE RVU (non-facility)
- 20.08
- PE RVU (facility)
- 20.08
- MP RVU
- 15.24
- Office payment
- $3,198.8
- Facility payment
- $3,198.8
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 43112 in a non-facility setting with national GPCI: (60.45 + 20.08 + 15.24) × $33.4009 ≈ $3,198.8. The same code in a facility setting pays about $3,198.8 because facility PE RVU (20.08) replaces office PE RVU.
What changes by locality
GPCI moves 43112 non-facility payment from $2,818.39 to $4,023.39 across CMS localities — from Wisconsin 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 43112?
60.45. 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 43112 in 2026?
About $3,198.8 non-facility ($3,198.8 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 (60.45) and malpractice RVU stay fixed; only practice expense changes (20.08 office vs 20.08 facility). That is the entire office-vs-facility payment gap.