CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43241 RVU and Medicare Payment (2026)
Egd tube/cath insertion — 2.43 work RVU, about $126.92 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.43
- PE RVU (non-facility)
- 1.07
- PE RVU (facility)
- 1.07
- MP RVU
- 0.3
- Office payment
- $126.92
- Facility payment
- $126.92
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 43241 in a non-facility setting with national GPCI: (2.43 + 1.07 + 0.3) × $33.4009 ≈ $126.92. The same code in a facility setting pays about $126.92 because facility PE RVU (1.07) replaces office PE RVU.
What changes by locality
GPCI moves 43241 non-facility payment from $117.02 to $165.33 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 43241?
2.43. 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 43241 in 2026?
About $126.92 non-facility ($126.92 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 (2.43) and malpractice RVU stay fixed; only practice expense changes (1.07 office vs 1.07 facility). That is the entire office-vs-facility payment gap.