CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43320 RVU and Medicare Payment (2026)
Fuse esophagus & stomach — 22.73 work RVU, about $1,307.98 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 22.73
- PE RVU (non-facility)
- 10.35
- PE RVU (facility)
- 10.35
- MP RVU
- 6.08
- Office payment
- $1,307.98
- Facility payment
- $1,307.98
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 43320 in a non-facility setting with national GPCI: (22.73 + 10.35 + 6.08) × $33.4009 ≈ $1,307.98. The same code in a facility setting pays about $1,307.98 because facility PE RVU (10.35) replaces office PE RVU.
What changes by locality
GPCI moves 43320 non-facility payment from $1,152.93 to $1,632.66 across CMS localities — from Wisconsin 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 43320?
22.73. 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 43320 in 2026?
About $1,307.98 non-facility ($1,307.98 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 (22.73) and malpractice RVU stay fixed; only practice expense changes (10.35 office vs 10.35 facility). That is the entire office-vs-facility payment gap.