CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43123 RVU and Medicare Payment (2026)
Partial removal of esophagus — 81.04 work RVU, about $4,175.45 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 81.04
- PE RVU (non-facility)
- 23.52
- PE RVU (facility)
- 23.52
- MP RVU
- 20.45
- Office payment
- $4,175.45
- Facility payment
- $4,175.45
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 43123 in a non-facility setting with national GPCI: (81.04 + 23.52 + 20.45) × $33.4009 ≈ $4,175.45. The same code in a facility setting pays about $4,175.45 because facility PE RVU (23.52) replaces office PE RVU.
What changes by locality
GPCI moves 43123 non-facility payment from $3,669.78 to $5,273.23 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 43123?
81.04. 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 43123 in 2026?
About $4,175.45 non-facility ($4,175.45 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 (81.04) 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.