CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 51020 RVU and Medicare Payment (2026)
Cystotomy/cystostomy w/fulg — 7.5 work RVU, about $435.55 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 7.5
- PE RVU (non-facility)
- 4.56
- PE RVU (facility)
- 4.56
- MP RVU
- 0.98
- Office payment
- $435.55
- Facility payment
- $435.55
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 51020 in a non-facility setting with national GPCI: (7.5 + 4.56 + 0.98) × $33.4009 ≈ $435.55. The same code in a facility setting pays about $435.55 because facility PE RVU (4.56) replaces office PE RVU.
What changes by locality
GPCI moves 51020 non-facility payment from $398.2 to $556 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 51020?
7.5. 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 51020 in 2026?
About $435.55 non-facility ($435.55 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 (7.5) and malpractice RVU stay fixed; only practice expense changes (4.56 office vs 4.56 facility). That is the entire office-vs-facility payment gap.