CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 45317 RVU and Medicare Payment (2026)
Proctosigmoidoscopy bleed — 1.85 work RVU, about $240.15 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.85
- PE RVU (non-facility)
- 5.04
- PE RVU (facility)
- 0.92
- MP RVU
- 0.3
- Office payment
- $240.15
- Facility payment
- $102.54
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 45317 in a non-facility setting with national GPCI: (1.85 + 5.04 + 0.3) × $33.4009 ≈ $240.15. The same code in a facility setting pays about $102.54 because facility PE RVU (0.92) replaces office PE RVU.
What changes by locality
GPCI moves 45317 non-facility payment from $211.56 to $316.71 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 45317?
1.85. 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 45317 in 2026?
About $240.15 non-facility ($102.54 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 (1.85) and malpractice RVU stay fixed; only practice expense changes (5.04 office vs 0.92 facility). That is the entire office-vs-facility payment gap.