CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 45520 RVU and Medicare Payment (2026)
Treatment of rectal prolapse — 0.54 work RVU, about $168.67 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.54
- PE RVU (non-facility)
- 4.44
- PE RVU (facility)
- 0.52
- MP RVU
- 0.07
- Office payment
- $168.67
- Facility payment
- $37.74
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 45520 in a non-facility setting with national GPCI: (0.54 + 4.44 + 0.07) × $33.4009 ≈ $168.67. The same code in a facility setting pays about $37.74 because facility PE RVU (0.52) replaces office PE RVU.
What changes by locality
GPCI moves 45520 non-facility payment from $146.63 to $235.12 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 45520?
0.54. 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 45520 in 2026?
About $168.67 non-facility ($37.74 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 (0.54) and malpractice RVU stay fixed; only practice expense changes (4.44 office vs 0.52 facility). That is the entire office-vs-facility payment gap.