CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 21820 RVU and Medicare Payment (2026)
Treat sternum fracture — 1.33 work RVU, about $179.7 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.33
- PE RVU (non-facility)
- 3.76
- PE RVU (facility)
- 3.44
- MP RVU
- 0.29
- Office payment
- $179.7
- Facility payment
- $169.01
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 21820 in a non-facility setting with national GPCI: (1.33 + 3.76 + 0.29) × $33.4009 ≈ $179.7. The same code in a facility setting pays about $169.01 because facility PE RVU (3.44) replaces office PE RVU.
What changes by locality
GPCI moves 21820 non-facility payment from $157.29 to $235.6 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 21820?
1.33. 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 21820 in 2026?
About $179.7 non-facility ($169.01 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 (1.33) and malpractice RVU stay fixed; only practice expense changes (3.76 office vs 3.44 facility). That is the entire office-vs-facility payment gap.