CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43116 RVU and Medicare Payment (2026)
Partial removal of esophagus — 90.67 work RVU, about $4,578.26 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 90.67
- PE RVU (non-facility)
- 23.52
- PE RVU (facility)
- 23.52
- MP RVU
- 22.88
- Office payment
- $4,578.26
- Facility payment
- $4,578.26
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 43116 in a non-facility setting with national GPCI: (90.67 + 23.52 + 22.88) × $33.4009 ≈ $4,578.26. The same code in a facility setting pays about $4,578.26 because facility PE RVU (23.52) replaces office PE RVU.
What changes by locality
GPCI moves 43116 non-facility payment from $4,016.43 to $5,800.42 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 43116?
90.67. 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 43116 in 2026?
About $4,578.26 non-facility ($4,578.26 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 (90.67) and malpractice RVU stay fixed; only practice expense changes (23.52 office vs 23.52 facility). That is the entire office-vs-facility payment gap.