CPT 51920 RVU Values & Medicare Payment 2026
Close bladder-uterus fistula
CPT 51920 is calculated with its CMS 2026 RVU components, the National Average GPCI locality, the non-facility practice expense setting, and the non-QPP conversion factor.
CPT 51920 setting and related-code comparison
Compare the same CPT under both PE settings, then review adjacent codes using National Average GPCI and the selected 2026 conversion factor.
| Setting | Work RVU | PE RVU | MP RVU | Total RVU | Payment |
|---|---|---|---|---|---|
| Non-facility | 13.07 | 5.99 | 1.68 | 20.74 | $692.73 |
| Facility | 13.07 | 5.99 | 1.68 | 20.74 | $692.73 |
| Related CPT | Descriptor | wRVU | Typical setting | National payment |
|---|---|---|---|---|
| CPT 51880 | Repair of bladder opening | 7.67 | Non-facility | $429.54 |
| CPT 51900 | Repair bladder/vagina lesion | 14.26 | Non-facility | $745.17 |
| CPT 51925 | Hysterectomy/bladder repair | 17.09 | Non-facility | $945.58 |
| CPT 51940 | Correction of bladder defect | 29.89 | Non-facility | $1,456.95 |
| CPT 99214 | Office o/p est mod 30 min | 1.92 | Non-facility | $135.61 |
CPT RVU and Medicare payment calculator
Search a CPT code, choose geography and participation status, then review work RVU, PE RVU, MP RVU, total RVU, and estimated Medicare payment. Use work RVU for productivity context and total RVU for Medicare payment estimates.
20.74 total RVU in National Average, National.
- Payment estimate: use total RVU and non-QPP $33.4009 for Medicare payment review.
- Productivity review: use work RVU separately; total RVU is not a physician productivity target.
- Before relying on it: confirm office / non-facility, National Average, and payer-specific billing rules.
Total RVU = work RVU x GPCI work + PE RVU x GPCI PE + MP RVU x GPCI MP. Payment = total RVU x selected 2026 conversion factor. Non-QPP uses $33.4009 and QPP uses $33.5675.
- CPT
- 51920
- Setting
- office / non-facility
- Conversion factor
- non-QPP $33.4009
- Work GPCI
- 1.000
- PE GPCI
- 1.000
- MP GPCI
- 1.000
Payment by representative localities
| Locality | wRVU | Total RVU | Medicare Payment |
|---|---|---|---|
| National: National Average | 13.07 | 20.74 | $692.73 |
| California: San Francisco | 13.07 | 22.65 | $756.53 |
| California: Los Angeles | 13.07 | 21.60 | $721.37 |
| New York: Manhattan | 13.07 | 23.53 | $785.97 |
| New York: Rest of New York | 13.07 | 21.57 | $720.40 |
| Texas: Dallas | 13.07 | 20.60 | $687.90 |
| Texas: Houston | 13.07 | 21.43 | $715.93 |
| Florida: Miami | 13.07 | 23.55 | $786.74 |
CPT 51920 code profile
CMS 2026 Physician Fee Schedule inputs for this CPT/HCPCS code, including the site-of-service assumption used for the payment examples on this page.
Close bladder-uterus fistula
- Typical setting
- Office / non-facility
- Specialty mapping
- Emergency Medicine
- Related codes
- 51880, 51900, 51925, 51940, 99214
RVU components are payment inputs, not clinical coding guidance. Confirm code selection, modifiers, payer policy, and documentation requirements through the official CMS source files or billing review. Locality-adjusted estimates should be interpreted with the selected setting, GPCI locality, and QPP status held constant.
How to interpret CPT 51920 RVU data
Use this panel to keep payment modeling, coding selection, and contract interpretation in separate lanes.
- RVU source
- CMS 2026 Physician Fee Schedule
- Payment basis
- Office / non-facility setting, national GPCI baseline
- Conversion factor
- 2026 non-QPP unless changed in the calculator
- Estimating Medicare payment from RVU components and GPCI assumptions.
- Comparing adjacent CPT codes after code selection is independently supported.
- Linking CPT-level RVU values to specialty productivity and compensation models.
- It does not decide whether the CPT code is clinically or documentation-supported.
- It does not replace payer-specific edits, modifier rules, or compliance review.
- It should not be mixed with a different setting or locality when comparing codes.
CPT FAQ
Common RVU and payment questions for CPT 51920.
What is the wRVU for CPT 51920?
The imported CMS 2026 Physician Fee Schedule source files list 13.07 work RVU for CPT 51920.
What is the national payment estimate for CPT 51920?
Using national GPCI and the 2026 non-QPP conversion factor, the estimate is $692.73.
Does locality change the payment?
Yes. GPCI values adjust work, practice expense, and malpractice components by geography.