CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 55520 RVU and Medicare Payment (2026)
Removal of sperm cord lesion — 6.49 work RVU, about $449.58 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.49
- PE RVU (non-facility)
- 5.33
- PE RVU (facility)
- 5.33
- MP RVU
- 1.64
- Office payment
- $449.58
- Facility payment
- $449.58
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 55520 in a non-facility setting with national GPCI: (6.49 + 5.33 + 1.64) × $33.4009 ≈ $449.58. The same code in a facility setting pays about $449.58 because facility PE RVU (5.33) replaces office PE RVU.
What changes by locality
GPCI moves 55520 non-facility payment from $397.91 to $544.94 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 55520?
6.49. 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 55520 in 2026?
About $449.58 non-facility ($449.58 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 (6.49) and malpractice RVU stay fixed; only practice expense changes (5.33 office vs 5.33 facility). That is the entire office-vs-facility payment gap.