CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 45160 RVU and Medicare Payment (2026)
Excision of rectal lesion — 15.92 work RVU, about $976.31 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 15.92
- PE RVU (non-facility)
- 9.06
- PE RVU (facility)
- 9.06
- MP RVU
- 4.25
- Office payment
- $976.31
- Facility payment
- $976.31
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 45160 in a non-facility setting with national GPCI: (15.92 + 9.06 + 4.25) × $33.4009 ≈ $976.31. The same code in a facility setting pays about $976.31 because facility PE RVU (9.06) replaces office PE RVU.
What changes by locality
GPCI moves 45160 non-facility payment from $864.71 to $1,205.76 across CMS localities — from Nebraska 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 45160?
15.92. 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 45160 in 2026?
About $976.31 non-facility ($976.31 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 (15.92) and malpractice RVU stay fixed; only practice expense changes (9.06 office vs 9.06 facility). That is the entire office-vs-facility payment gap.