That cartridge is indeed ultra low output. The ideal partner would be a SUT with a turns ratio of about 1:45. That would give about 33dB gain and give you enough signal to feed into an MM phonostage. Ortofon used to sell transformers specifically for those ultra low output cartridges. A lot of the Denon transformers have a turns ratio of only 1:10 which isn't really high enough for the MC-20 but you might get away with it if the MM phonostage could be adjusted for a gain of about 50dB rather than the more usual 40dB.
The real issue isn't so much the amount of gain required, it's getting a good signal-to-noise ratio. A high ratio SUT would be best, but even a low ratio SUT would help.
Is it all worth the cost? I suppose that depends on how much a re-tip is going to cost and whether you can find a suitable SUT at a reasonable cost.
That cartridge requires a gain of about 70-75dB. 30dB from a SUT + 40dB from a phonostage would do it, or 20dB for a SUT + 50dB from a phonostage. Btw, the phonostage would need a 47k input impedance for the SUT to work correctly, so there's no point trying to use an MC phonostage for extra gain if it has a low input impedance (circa 100 ohms).