CPT 12011 Surgery - Integumentary
Rpr f/e/e/n/l/m 2.5 cm/< Cost
Body System: Integumentary
Medicare Facility Rate
$54
CMS PFS CY2026
Medicare Non-Facility Rate
$140
Office/clinic setting
Hospital Outpatient
$205
OPPS rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
1.04
Work RVU
0.36
Facility PE RVU
0.23
Malpractice RVU
4.18
Total RVU
Frequently Asked Questions
How much does Rpr f/e/e/n/l/m 2.5 cm/< cost?
The Medicare facility rate is $54. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $205.
How much does Rpr f/e/e/n/l/m 2.5 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 $54.