CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 45378 RVU and Medicare Payment (2026)
Diagnostic colonoscopy — 3.18 work RVU, about $378.1 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.18
- PE RVU (non-facility)
- 7.73
- PE RVU (facility)
- 1.34
- MP RVU
- 0.41
- Office payment
- $378.1
- Facility payment
- $164.67
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 45378 in a non-facility setting with national GPCI: (3.18 + 7.73 + 0.41) × $33.4009 ≈ $378.1. The same code in a facility setting pays about $164.67 because facility PE RVU (1.34) replaces office PE RVU.
What changes by locality
GPCI moves 45378 non-facility payment from $335.05 to $497.55 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 45378?
3.18. 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 45378 in 2026?
About $378.1 non-facility ($164.67 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 (3.18) and malpractice RVU stay fixed; only practice expense changes (7.73 office vs 1.34 facility). That is the entire office-vs-facility payment gap.