CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 23020 RVU and Medicare Payment (2026)
Capsular contracture release — 9.13 work RVU, about $650.65 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.13
- PE RVU (non-facility)
- 8.44
- PE RVU (facility)
- 8.44
- MP RVU
- 1.91
- Office payment
- $650.65
- Facility payment
- $650.65
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 23020 in a non-facility setting with national GPCI: (9.13 + 8.44 + 1.91) × $33.4009 ≈ $650.65. The same code in a facility setting pays about $650.65 because facility PE RVU (8.44) replaces office PE RVU.
What changes by locality
GPCI moves 23020 non-facility payment from $579.96 to $792.8 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 23020?
9.13. 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 23020 in 2026?
About $650.65 non-facility ($650.65 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 (9.13) and malpractice RVU stay fixed; only practice expense changes (8.44 office vs 8.44 facility). That is the entire office-vs-facility payment gap.