CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 45320 RVU and Medicare Payment (2026)
Proctosigmoidoscopy ablate — 1.64 work RVU, about $245.83 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.64
- PE RVU (non-facility)
- 5.29
- PE RVU (facility)
- 0.91
- MP RVU
- 0.43
- Office payment
- $245.83
- Facility payment
- $99.53
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 45320 in a non-facility setting with national GPCI: (1.64 + 5.29 + 0.43) × $33.4009 ≈ $245.83. The same code in a facility setting pays about $99.53 because facility PE RVU (0.91) replaces office PE RVU.
What changes by locality
GPCI moves 45320 non-facility payment from $213.95 to $323.29 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 45320?
1.64. 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 45320 in 2026?
About $245.83 non-facility ($99.53 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 (1.64) and malpractice RVU stay fixed; only practice expense changes (5.29 office vs 0.91 facility). That is the entire office-vs-facility payment gap.