CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43233 RVU and Medicare Payment (2026)
Egd balloon dil esoph30 mm/> — 3.97 work RVU, about $204.08 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.97
- PE RVU (non-facility)
- 1.52
- PE RVU (facility)
- 1.52
- MP RVU
- 0.62
- Office payment
- $204.08
- Facility payment
- $204.08
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 43233 in a non-facility setting with national GPCI: (3.97 + 1.52 + 0.62) × $33.4009 ≈ $204.08. The same code in a facility setting pays about $204.08 because facility PE RVU (1.52) replaces office PE RVU.
What changes by locality
GPCI moves 43233 non-facility payment from $186.88 to $264.38 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 43233?
3.97. 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 43233 in 2026?
About $204.08 non-facility ($204.08 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 (3.97) and malpractice RVU stay fixed; only practice expense changes (1.52 office vs 1.52 facility). That is the entire office-vs-facility payment gap.