CPT 12045 Surgery - Integumentary
Intmd rpr n-hf/genit12.6-20 Cost
Body System: Integumentary
Medicare Facility Rate
$269
CMS PFS CY2026
Medicare Non-Facility Rate
$454
Office/clinic setting
Hospital Outpatient
$755
OPPS rate
Surgery Center (ASC)
$405
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
3.66
Work RVU
3.68
Facility PE RVU
0.70
Malpractice RVU
13.58
Total RVU
Frequently Asked Questions
How much does Intmd rpr n-hf/genit12.6-20 cost?
The Medicare facility rate is $269. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $755. Ambulatory surgery center rate: $405.
How much does Intmd rpr n-hf/genit12.6-20 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 $269.