CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 45563 RVU and Medicare Payment (2026)
Exploration/repair of rectum — 25.72 work RVU, about $1,569.84 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 25.72
- PE RVU (non-facility)
- 14.42
- PE RVU (facility)
- 14.42
- MP RVU
- 6.86
- Office payment
- $1,569.84
- Facility payment
- $1,569.84
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 45563 in a non-facility setting with national GPCI: (25.72 + 14.42 + 6.86) × $33.4009 ≈ $1,569.84. The same code in a facility setting pays about $1,569.84 because facility PE RVU (14.42) replaces office PE RVU.
What changes by locality
GPCI moves 45563 non-facility payment from $1,390.24 to $1,939.93 across CMS localities — from Nebraska to Miami. 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 45563?
25.72. 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 45563 in 2026?
About $1,569.84 non-facility ($1,569.84 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 (25.72) and malpractice RVU stay fixed; only practice expense changes (14.42 office vs 14.42 facility). That is the entire office-vs-facility payment gap.