CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 51920 RVU and Medicare Payment (2026)
Close bladder-uterus fistula — 13.07 work RVU, about $692.73 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 13.07
- PE RVU (non-facility)
- 5.99
- PE RVU (facility)
- 5.99
- MP RVU
- 1.68
- Office payment
- $692.73
- Facility payment
- $692.73
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 51920 in a non-facility setting with national GPCI: (13.07 + 5.99 + 1.68) × $33.4009 ≈ $692.73. The same code in a facility setting pays about $692.73 because facility PE RVU (5.99) replaces office PE RVU.
What changes by locality
GPCI moves 51920 non-facility payment from $637.31 to $898.82 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 51920?
13.07. 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 51920 in 2026?
About $692.73 non-facility ($692.73 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 (13.07) and malpractice RVU stay fixed; only practice expense changes (5.99 office vs 5.99 facility). That is the entire office-vs-facility payment gap.