CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 20240 RVU and Medicare Payment (2026)
Bone biopsy open superficial — 2.54 work RVU, about $126.59 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.54
- PE RVU (non-facility)
- 0.95
- PE RVU (facility)
- 0.95
- MP RVU
- 0.3
- Office payment
- $126.59
- Facility payment
- $126.59
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 20240 in a non-facility setting with national GPCI: (2.54 + 0.95 + 0.3) × $33.4009 ≈ $126.59. The same code in a facility setting pays about $126.59 because facility PE RVU (0.95) replaces office PE RVU.
What changes by locality
GPCI moves 20240 non-facility payment from $117.26 to $166.57 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 20240?
2.54. 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 20240 in 2026?
About $126.59 non-facility ($126.59 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 (2.54) and malpractice RVU stay fixed; only practice expense changes (0.95 office vs 0.95 facility). That is the entire office-vs-facility payment gap.