CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43210 RVU and Medicare Payment (2026)
Egd esophagogastrc fndoplsty — 7.56 work RVU, about $379.43 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 7.56
- PE RVU (non-facility)
- 2.7
- PE RVU (facility)
- 2.7
- MP RVU
- 1.1
- Office payment
- $379.43
- Facility payment
- $379.43
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 43210 in a non-facility setting with national GPCI: (7.56 + 2.7 + 1.1) × $33.4009 ≈ $379.43. The same code in a facility setting pays about $379.43 because facility PE RVU (2.7) replaces office PE RVU.
What changes by locality
GPCI moves 43210 non-facility payment from $348.9 to $495.05 across CMS localities — from Arkansas 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 43210?
7.56. 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 43210 in 2026?
About $379.43 non-facility ($379.43 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 (7.56) and malpractice RVU stay fixed; only practice expense changes (2.7 office vs 2.7 facility). That is the entire office-vs-facility payment gap.