CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 55120 RVU and Medicare Payment (2026)
Removal of scrotum lesion — 5.58 work RVU, about $331.34 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.58
- PE RVU (non-facility)
- 3.63
- PE RVU (facility)
- 3.63
- MP RVU
- 0.71
- Office payment
- $331.34
- Facility payment
- $331.34
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 55120 in a non-facility setting with national GPCI: (5.58 + 3.63 + 0.71) × $33.4009 ≈ $331.34. The same code in a facility setting pays about $331.34 because facility PE RVU (3.63) replaces office PE RVU.
What changes by locality
GPCI moves 55120 non-facility payment from $302.74 to $421.76 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 55120?
5.58. 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 55120 in 2026?
About $331.34 non-facility ($331.34 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 (5.58) and malpractice RVU stay fixed; only practice expense changes (3.63 office vs 3.63 facility). That is the entire office-vs-facility payment gap.