CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 45389 RVU and Medicare Payment (2026)
Colonoscopy w/stent plcmt — 5.11 work RVU, about $253.18 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.11
- PE RVU (non-facility)
- 1.89
- PE RVU (facility)
- 1.89
- MP RVU
- 0.58
- Office payment
- $253.18
- Facility payment
- $253.18
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 45389 in a non-facility setting with national GPCI: (5.11 + 1.89 + 0.58) × $33.4009 ≈ $253.18. The same code in a facility setting pays about $253.18 because facility PE RVU (1.89) replaces office PE RVU.
What changes by locality
GPCI moves 45389 non-facility payment from $234.88 to $333.92 across CMS localities — from Arkansas to Alaska. 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 45389?
5.11. 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 45389 in 2026?
About $253.18 non-facility ($253.18 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 (5.11) and malpractice RVU stay fixed; only practice expense changes (1.89 office vs 1.89 facility). That is the entire office-vs-facility payment gap.