CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43206 RVU and Medicare Payment (2026)
Esoph optical endomicroscopy — 2.23 work RVU, about $340.36 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.23
- PE RVU (non-facility)
- 7.72
- PE RVU (facility)
- 1.08
- MP RVU
- 0.24
- Office payment
- $340.36
- Facility payment
- $118.57
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 43206 in a non-facility setting with national GPCI: (2.23 + 7.72 + 0.24) × $33.4009 ≈ $340.36. The same code in a facility setting pays about $118.57 because facility PE RVU (1.08) replaces office PE RVU.
What changes by locality
GPCI moves 43206 non-facility payment from $300.11 to $458.8 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 43206?
2.23. 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 43206 in 2026?
About $340.36 non-facility ($118.57 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 (2.23) and malpractice RVU stay fixed; only practice expense changes (7.72 office vs 1.08 facility). That is the entire office-vs-facility payment gap.