CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43113 RVU and Medicare Payment (2026)
Removal of esophagus — 78.06 work RVU, about $4,031.15 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 78.06
- PE RVU (non-facility)
- 22.93
- PE RVU (facility)
- 22.93
- MP RVU
- 19.7
- Office payment
- $4,031.15
- Facility payment
- $4,031.15
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 43113 in a non-facility setting with national GPCI: (78.06 + 22.93 + 19.7) × $33.4009 ≈ $4,031.15. The same code in a facility setting pays about $4,031.15 because facility PE RVU (22.93) replaces office PE RVU.
What changes by locality
GPCI moves 43113 non-facility payment from $3,543.65 to $5,089.13 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 43113?
78.06. 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 43113 in 2026?
About $4,031.15 non-facility ($4,031.15 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 (78.06) and malpractice RVU stay fixed; only practice expense changes (22.93 office vs 22.93 facility). That is the entire office-vs-facility payment gap.