CPT 11626 Surgery - Integumentary

Exc s/n/h/f/g mal+mrg >4 cm Cost

Body System: Integumentary

Medicare Facility Rate
$254
CMS PFS CY2026
Medicare Non-Facility Rate
$419
Office/clinic setting
Hospital Outpatient
$2
OPPS rate
Surgery Center (ASC)
$1
ASC rate

Relative Value Units (RVUs)

Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)

4.49
Work RVU
2.36
Facility PE RVU
0.76
Malpractice RVU
12.55
Total RVU

Frequently Asked Questions

How much does Exc s/n/h/f/g mal+mrg >4 cm cost?

The Medicare facility rate is $254. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $2. Ambulatory surgery center rate: $1.

How much does Exc s/n/h/f/g mal+mrg >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 $254.

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