CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43285 RVU and Medicare Payment (2026)
Rmvl esophgl sphnctr dev — 10.21 work RVU, about $643.64 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 10.21
- PE RVU (non-facility)
- 6.33
- PE RVU (facility)
- 6.33
- MP RVU
- 2.73
- Office payment
- $643.64
- Facility payment
- $643.64
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 43285 in a non-facility setting with national GPCI: (10.21 + 6.33 + 2.73) × $33.4009 ≈ $643.64. The same code in a facility setting pays about $643.64 because facility PE RVU (6.33) replaces office PE RVU.
What changes by locality
GPCI moves 43285 non-facility payment from $569.6 to $791.72 across CMS localities — from Arkansas to Miami. 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 43285?
10.21. 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 43285 in 2026?
About $643.64 non-facility ($643.64 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 (10.21) and malpractice RVU stay fixed; only practice expense changes (6.33 office vs 6.33 facility). That is the entire office-vs-facility payment gap.