CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 20956 RVU and Medicare Payment (2026)
Iliac bone graft microvasc — 40.15 work RVU, about $2,355.43 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 40.15
- PE RVU (non-facility)
- 21.79
- PE RVU (facility)
- 21.79
- MP RVU
- 8.58
- Office payment
- $2,355.43
- Facility payment
- $2,355.43
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 20956 in a non-facility setting with national GPCI: (40.15 + 21.79 + 8.58) × $33.4009 ≈ $2,355.43. The same code in a facility setting pays about $2,355.43 because facility PE RVU (21.79) replaces office PE RVU.
What changes by locality
GPCI moves 20956 non-facility payment from $2,113.82 to $2,944.59 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 20956?
40.15. 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 20956 in 2026?
About $2,355.43 non-facility ($2,355.43 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 (40.15) and malpractice RVU stay fixed; only practice expense changes (21.79 office vs 21.79 facility). That is the entire office-vs-facility payment gap.