CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 49520 RVU and Medicare Payment (2026)
Rerepair ing hernia reduce — 9.74 work RVU, about $608.23 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.74
- PE RVU (non-facility)
- 5.91
- PE RVU (facility)
- 5.91
- MP RVU
- 2.56
- Office payment
- $608.23
- Facility payment
- $608.23
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 49520 in a non-facility setting with national GPCI: (9.74 + 5.91 + 2.56) × $33.4009 ≈ $608.23. The same code in a facility setting pays about $608.23 because facility PE RVU (5.91) replaces office PE RVU.
What changes by locality
GPCI moves 49520 non-facility payment from $538.93 to $747.06 across CMS localities — from Arkansas to Miami. 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 49520?
9.74. 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 49520 in 2026?
About $608.23 non-facility ($608.23 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 (9.74) and malpractice RVU stay fixed; only practice expense changes (5.91 office vs 5.91 facility). That is the entire office-vs-facility payment gap.