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CPT 43245 — Egd dilate stricture

CPT code 43245 (Egd dilate stricture) carries 3.0 work RVUs under the CMS 2026 Medicare Physician Fee Schedule. Total RVUs are 19.61 in a non-facility setting and 4.7 in a facility setting, which at the 2026 conversion factor of $33.40 works out to $654.99 and $156.98 respectively.

3.0
Work RVU
19.61
Total RVU (non-facility)
$654.99
Medicare, non-facility
$156.98
Medicare, facility
Calculate your total wRVUs →

RVU breakdown for CPT 43245

ComponentRVUsWhat it covers
Work RVU3.0Physician time, skill, effort, and stress.
Practice expense RVU (non-facility)16.19Office overhead, staff, supplies.
Practice expense RVU (facility)1.28Overhead when performed in a hospital.
Malpractice RVU0.42Professional liability cost.
Total RVU (non-facility)19.61Work + non-facility PE + malpractice.
Total RVU (facility)4.7Work + facility PE + malpractice.

How Medicare payment is calculated

Medicare multiplies total RVUs by the annual conversion factor. For CPT 43245 in 2026:

SettingTotal RVUConversion factorNational payment
Non-facility19.61$33.40$654.99
Facility4.7$33.40$156.98

These are national amounts. Actual payment is adjusted by the Geographic Practice Cost Index for your locality — check yours with the GPCI lookup.

Billing rules for CPT 43245

Global period
0-day global — no pre- or post-operative period included.
Multiple procedure reduction
Subject to the multiple-endoscopy payment rule.
Bilateral surgery
Bilateral adjustment does not apply.
Assistant surgeon
Not permitted.
Co-surgeon
Not permitted unless documentation supports medical necessity.
Team surgery
Not permitted unless documentation supports medical necessity.

Related codes

Codes in the same CMS family, with their work RVU values.

43231 · 2.73 wRVU43232 · 3.5 wRVU43233 · 3.97 wRVU43235 · 2.04 wRVU43236 · 2.33 wRVU43237 · 3.38 wRVU43238 · 4.06 wRVU43239 · 2.33 wRVU

Questions about CPT 43245

How many work RVUs is CPT 43245?

CPT 43245 is assigned 3.0 work RVUs in the CMS 2026 Medicare Physician Fee Schedule.

What does Medicare pay for CPT 43245?

At the 2026 national conversion factor of $33.40, CPT 43245 pays approximately $654.99 in a non-facility setting and $156.98 in a facility setting before geographic adjustment.

What is the global period for CPT 43245?

0-day global — no pre- or post-operative period included.

RVU values reflect the CMS 2026 Medicare Physician Fee Schedule (conversion factor $33.40). Payment figures are national and unadjusted for geography. Verify against the official fee schedule before using for billing.