CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43860 RVU and Medicare Payment (2026)
Revj gstr/jj anast w/o vgtmy — 27.19 work RVU, about $1,516.07 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 27.19
- PE RVU (non-facility)
- 11.29
- PE RVU (facility)
- 11.29
- MP RVU
- 6.91
- Office payment
- $1,516.07
- Facility payment
- $1,516.07
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 43860 in a non-facility setting with national GPCI: (27.19 + 11.29 + 6.91) × $33.4009 ≈ $1,516.07. The same code in a facility setting pays about $1,516.07 because facility PE RVU (11.29) replaces office PE RVU.
What changes by locality
GPCI moves 43860 non-facility payment from $1,340.52 to $1,891.03 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 43860?
27.19. 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 43860 in 2026?
About $1,516.07 non-facility ($1,516.07 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 (27.19) and malpractice RVU stay fixed; only practice expense changes (11.29 office vs 11.29 facility). That is the entire office-vs-facility payment gap.