CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 91040 RVU and Medicare Payment (2026)
Esoph balloon distension tst — 0.95 work RVU, about $576.83 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.95
- PE RVU (non-facility)
- 16.24
- PE RVU (facility)
- 16.24
- MP RVU
- 0.08
- Office payment
- $576.83
- Facility payment
- $576.83
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 91040 in a non-facility setting with national GPCI: (0.95 + 16.24 + 0.08) × $33.4009 ≈ $576.83. The same code in a facility setting pays about $576.83 because facility PE RVU (16.24) replaces office PE RVU.
What changes by locality
GPCI moves 91040 non-facility payment from $499.05 to $818.84 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 91040?
0.95. 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 91040 in 2026?
About $576.83 non-facility ($576.83 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 (0.95) and malpractice RVU stay fixed; only practice expense changes (16.24 office vs 16.24 facility). That is the entire office-vs-facility payment gap.