CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 45384 RVU and Medicare Payment (2026)
Colonoscopy w/lesion removal — 3.97 work RVU, about $539.42 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.97
- PE RVU (non-facility)
- 11.57
- PE RVU (facility)
- 1.51
- MP RVU
- 0.61
- Office payment
- $539.42
- Facility payment
- $203.41
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 45384 in a non-facility setting with national GPCI: (3.97 + 11.57 + 0.61) × $33.4009 ≈ $539.42. The same code in a facility setting pays about $203.41 because facility PE RVU (1.51) replaces office PE RVU.
What changes by locality
GPCI moves 45384 non-facility payment from $475.05 to $715.37 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 45384?
3.97. 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 45384 in 2026?
About $539.42 non-facility ($203.41 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 (3.97) and malpractice RVU stay fixed; only practice expense changes (11.57 office vs 1.51 facility). That is the entire office-vs-facility payment gap.