CPT 21080 Surgery - Musculoskeletal

How Much Does Impres&prep def obt prosth Cost?

Impres&prep def obt prosth (CPT 21080) costs $1,163 at Medicare rates. Hospital outpatient rate: $3.

Cost Comparison by Payer

How much Impres&prep def obt prosth costs across different settings and payers

Medicare
Facility rate
$1,163
Hospital Outpatient
OPPS rate
$3
Surgery Center
ASC rate
$821
Medicare (Facility)
$1,163
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$1,730
Non-facility setting
Hospital Outpatient
$3
OPPS rate
Surgery Center (ASC)
$821
Ambulatory surgery center

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How to Reduce Your Cost for Impres&prep def obt prosth

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 ($1,730) differs from the facility rate ($1,163). 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 $821, compared to $3 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.

24.43
Work RVU
7.48
Practice Expense RVU
2.91
Malpractice RVU
51.79
Total RVU

Payment = Total RVU (51.79) x CF ($33.40) = $1,730

Frequently Asked Questions

How much does Impres&prep def obt prosth cost?

The Medicare facility rate for Impres&prep def obt prosth is $1,163. In a hospital outpatient setting, the rate is $3. At an ambulatory surgery center, the rate is $821. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Impres&prep def obt prosth cost without insurance?

Without insurance, the cost of Impres&prep def obt prosth 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 Impres&prep def obt prosth?

Most commercial health insurance plans and Medicare cover Impres&prep def obt prosth 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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