CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 56420 RVU and Medicare Payment (2026)
I&d bartholins gland abscess — 1.4 work RVU, about $182.03 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.4
- PE RVU (non-facility)
- 3.81
- PE RVU (facility)
- 1.36
- MP RVU
- 0.24
- Office payment
- $182.03
- Facility payment
- $100.2
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 56420 in a non-facility setting with national GPCI: (1.4 + 3.81 + 0.24) × $33.4009 ≈ $182.03. The same code in a facility setting pays about $100.2 because facility PE RVU (1.36) replaces office PE RVU.
What changes by locality
GPCI moves 56420 non-facility payment from $160.2 to $239.71 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). 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 56420?
1.4. 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 56420 in 2026?
About $182.03 non-facility ($100.2 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 (1.4) and malpractice RVU stay fixed; only practice expense changes (3.81 office vs 1.36 facility). That is the entire office-vs-facility payment gap.