CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43450 RVU and Medicare Payment (2026)
Dilate esophagus 1/mult pass — 1.25 work RVU, about $212.1 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.25
- PE RVU (non-facility)
- 4.95
- PE RVU (facility)
- 0.79
- MP RVU
- 0.15
- Office payment
- $212.1
- Facility payment
- $73.15
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 43450 in a non-facility setting with national GPCI: (1.25 + 4.95 + 0.15) × $33.4009 ≈ $212.1. The same code in a facility setting pays about $73.15 because facility PE RVU (0.79) replaces office PE RVU.
What changes by locality
GPCI moves 43450 non-facility payment from $186.35 to $287.44 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 43450?
1.25. 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 43450 in 2026?
About $212.1 non-facility ($73.15 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 (1.25) and malpractice RVU stay fixed; only practice expense changes (4.95 office vs 0.79 facility). That is the entire office-vs-facility payment gap.