CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43610 RVU and Medicare Payment (2026)
Excision of stomach lesion — 15.93 work RVU, about $919.86 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 15.93
- PE RVU (non-facility)
- 7.54
- PE RVU (facility)
- 7.54
- MP RVU
- 4.07
- Office payment
- $919.86
- Facility payment
- $919.86
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 43610 in a non-facility setting with national GPCI: (15.93 + 7.54 + 4.07) × $33.4009 ≈ $919.86. The same code in a facility setting pays about $919.86 because facility PE RVU (7.54) replaces office PE RVU.
What changes by locality
GPCI moves 43610 non-facility payment from $815.21 to $1,141.23 across CMS localities — from Wisconsin 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 43610?
15.93. 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 43610 in 2026?
About $919.86 non-facility ($919.86 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 (15.93) and malpractice RVU stay fixed; only practice expense changes (7.54 office vs 7.54 facility). That is the entire office-vs-facility payment gap.