CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 20250 RVU and Medicare Payment (2026)
Biopsy vrt bdy open thoracic — 5.06 work RVU, about $387.45 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.06
- PE RVU (non-facility)
- 5.08
- PE RVU (facility)
- 5.08
- MP RVU
- 1.46
- Office payment
- $387.45
- Facility payment
- $387.45
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 20250 in a non-facility setting with national GPCI: (5.06 + 5.08 + 1.46) × $33.4009 ≈ $387.45. The same code in a facility setting pays about $387.45 because facility PE RVU (5.08) replaces office PE RVU.
What changes by locality
GPCI moves 20250 non-facility payment from $339.87 to $472.13 across CMS localities — from Arkansas to Nyc Suburbs/long Island. 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 20250?
5.06. 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 20250 in 2026?
About $387.45 non-facility ($387.45 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 (5.06) and malpractice RVU stay fixed; only practice expense changes (5.08 office vs 5.08 facility). That is the entire office-vs-facility payment gap.