CPT 21011 Surgery - Musculoskeletal

How Much Does Excision Face Les Sc Less than 2 Cm Cost?

Also known as: Exc face les sc <2 cm (CPT 21011)

Excision Face Les Sc Less than 2 Cm (CPT 21011) costs $250 at Medicare rates. Hospital outpatient rate: $1.

Cost Comparison by Payer

How much Exc face les sc <2 cm costs across different settings and payers

Medicare
Facility rate
$250
Hospital Outpatient
OPPS rate
$1
Surgery Center
ASC rate
$281
Medicare (Facility)
$250
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$395
Non-facility setting
Hospital Outpatient
$1
OPPS rate
Surgery Center (ASC)
$281
Ambulatory surgery center

Procedures Commonly Done Together

These procedures are frequently performed alongside Exc face les sc <2 cm

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How to Reduce Your Cost for Exc face les sc <2 cm

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($395) differs from the facility rate ($250). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $281, compared to $1 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

2.92
Work RVU
4.04
Practice Expense RVU
0.53
Malpractice RVU
11.83
Total RVU

Payment = Total RVU (11.83) x CF ($33.40) = $395

Frequently Asked Questions

How much does Exc face les sc <2 cm cost?

The Medicare facility rate for Exc face les sc <2 cm is $250. In a hospital outpatient setting, the rate is $1. At an ambulatory surgery center, the rate is $281. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Exc face les sc <2 cm cost without insurance?

Without insurance, the cost of Exc face les sc <2 cm can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Exc face les sc <2 cm?

Most commercial health insurance plans and Medicare cover Exc face les sc <2 cm when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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