CPT 11604 Surgery - Integumentary
Exc tr-ext mal+marg 3.1-4 cm Cost
Body System: Integumentary
Medicare Facility Rate
$181
CMS PFS CY2026
Medicare Non-Facility Rate
$311
Office/clinic setting
Hospital Outpatient
$723
OPPS rate
Surgery Center (ASC)
$389
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
3.09
Work RVU
1.93
Facility PE RVU
0.40
Malpractice RVU
9.31
Total RVU
Frequently Asked Questions
How much does Exc tr-ext mal+marg 3.1-4 cm cost?
The Medicare facility rate is $181. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $723. Ambulatory surgery center rate: $389.
How much does Exc tr-ext mal+marg 3.1-4 cm 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 $181.