CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43261 RVU and Medicare Payment (2026)
Endo cholangiopancreatograph — 6 work RVU, about $295.6 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6
- PE RVU (non-facility)
- 2.18
- PE RVU (facility)
- 2.18
- MP RVU
- 0.67
- Office payment
- $295.6
- Facility payment
- $295.6
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 43261 in a non-facility setting with national GPCI: (6 + 2.18 + 0.67) × $33.4009 ≈ $295.6. The same code in a facility setting pays about $295.6 because facility PE RVU (2.18) replaces office PE RVU.
What changes by locality
GPCI moves 43261 non-facility payment from $274.48 to $390.49 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 43261?
6. 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 43261 in 2026?
About $295.6 non-facility ($295.6 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 (6) and malpractice RVU stay fixed; only practice expense changes (2.18 office vs 2.18 facility). That is the entire office-vs-facility payment gap.