CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 19020 RVU and Medicare Payment (2026)
Mastotomy expl drg absc dp — 3.73 work RVU, about $514.37 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.73
- PE RVU (non-facility)
- 10.75
- PE RVU (facility)
- 4.82
- MP RVU
- 0.92
- Office payment
- $514.37
- Facility payment
- $316.31
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 19020 in a non-facility setting with national GPCI: (3.73 + 10.75 + 0.92) × $33.4009 ≈ $514.37. The same code in a facility setting pays about $316.31 because facility PE RVU (4.82) replaces office PE RVU.
What changes by locality
GPCI moves 19020 non-facility payment from $448.84 to $672.52 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 19020?
3.73. 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 19020 in 2026?
About $514.37 non-facility ($316.31 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 (3.73) and malpractice RVU stay fixed; only practice expense changes (10.75 office vs 4.82 facility). That is the entire office-vs-facility payment gap.