CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 53220 RVU and Medicare Payment (2026)
Treatment of urethra lesion — 7.44 work RVU, about $415.84 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 7.44
- PE RVU (non-facility)
- 4.05
- PE RVU (facility)
- 4.05
- MP RVU
- 0.96
- Office payment
- $415.84
- Facility payment
- $415.84
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 53220 in a non-facility setting with national GPCI: (7.44 + 4.05 + 0.96) × $33.4009 ≈ $415.84. The same code in a facility setting pays about $415.84 because facility PE RVU (4.05) replaces office PE RVU.
What changes by locality
GPCI moves 53220 non-facility payment from $381.22 to $534.49 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 53220?
7.44. 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 53220 in 2026?
About $415.84 non-facility ($415.84 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 (7.44) and malpractice RVU stay fixed; only practice expense changes (4.05 office vs 4.05 facility). That is the entire office-vs-facility payment gap.