CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 20245 RVU and Medicare Payment (2026)
Bone biopsy open deep — 5.85 work RVU, about $303.28 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.85
- PE RVU (non-facility)
- 2.18
- PE RVU (facility)
- 2.18
- MP RVU
- 1.05
- Office payment
- $303.28
- Facility payment
- $303.28
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 20245 in a non-facility setting with national GPCI: (5.85 + 2.18 + 1.05) × $33.4009 ≈ $303.28. The same code in a facility setting pays about $303.28 because facility PE RVU (2.18) replaces office PE RVU.
What changes by locality
GPCI moves 20245 non-facility payment from $275.86 to $389.96 across CMS localities — from Nebraska 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 20245?
5.85. 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 20245 in 2026?
About $303.28 non-facility ($303.28 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 (5.85) and malpractice RVU stay fixed; only practice expense changes (2.18 office vs 2.18 facility). That is the entire office-vs-facility payment gap.