CPT 12016 Surgery - Integumentary
Rpr fe/e/en/l/m 12.6-20.0 cm Cost
Body System: Integumentary
Medicare Facility Rate
$122
CMS PFS CY2026
Medicare Non-Facility Rate
$268
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)
2.61
Work RVU
0.44
Facility PE RVU
0.61
Malpractice RVU
8.01
Total RVU
Frequently Asked Questions
How much does Rpr fe/e/en/l/m 12.6-20.0 cm cost?
The Medicare facility rate is $122. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $415. Ambulatory surgery center rate: $223.
How much does Rpr fe/e/en/l/m 12.6-20.0 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 $122.