CPT 12055 Surgery - Integumentary
Intmd rpr face/mm 12.6-20 cm Cost
Body System: Integumentary
Medicare Facility Rate
$294
CMS PFS CY2026
Medicare Non-Facility Rate
$546
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)
4.39
Work RVU
3.54
Facility PE RVU
0.88
Malpractice RVU
16.34
Total RVU
Frequently Asked Questions
How much does Intmd rpr face/mm 12.6-20 cm cost?
The Medicare facility rate is $294. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $415. Ambulatory surgery center rate: $223.
How much does Intmd rpr face/mm 12.6-20 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 $294.