CPT 13120 Surgery - Integumentary
Cmplx rpr s/a/l 1.1-2.5 cm Cost
Body System: Integumentary
Medicare Facility Rate
$198
CMS PFS CY2026
Medicare Non-Facility Rate
$351
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)
3.15
Work RVU
2.41
Facility PE RVU
0.38
Malpractice RVU
10.51
Total RVU
Frequently Asked Questions
How much does Cmplx rpr s/a/l 1.1-2.5 cm cost?
The Medicare facility rate is $198. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $415. Ambulatory surgery center rate: $223.
How much does Cmplx rpr s/a/l 1.1-2.5 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 $198.