CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 20555 RVU and Medicare Payment (2026)
Place ndl musc/tis for rt — 5.85 work RVU, about $279.57 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.85
- PE RVU (non-facility)
- 2.06
- PE RVU (facility)
- 2.06
- MP RVU
- 0.46
- Office payment
- $279.57
- Facility payment
- $279.57
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 20555 in a non-facility setting with national GPCI: (5.85 + 2.06 + 0.46) × $33.4009 ≈ $279.57. The same code in a facility setting pays about $279.57 because facility PE RVU (2.06) replaces office PE RVU.
What changes by locality
GPCI moves 20555 non-facility payment from $262.41 to $374.84 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 20555?
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 20555 in 2026?
About $279.57 non-facility ($279.57 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 (2.06 office vs 2.06 facility). That is the entire office-vs-facility payment gap.