CPT 11042 Surgery - Integumentary
Dbrdmt subq tis 1st 20sqcm/< Cost
Body System: Integumentary
Medicare Facility Rate
$56
CMS PFS CY2026
Medicare Non-Facility Rate
$133
Office/clinic setting
Hospital Outpatient
$415
OPPS rate
Surgery Center (ASC)
$223
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.98
Work RVU
0.56
Facility PE RVU
0.13
Malpractice RVU
3.97
Total RVU
Frequently Asked Questions
How much does Dbrdmt subq tis 1st 20sqcm/< cost?
The Medicare facility rate is $56. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $415. Ambulatory surgery center rate: $223.
How much does Dbrdmt subq tis 1st 20sqcm/< cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $56.