CPT 20102 Surgery - Musculoskeletal
Expl pentrg wnd abd/flnk/bk Cost
Body System: Musculoskeletal
Medicare Facility Rate
$245
CMS PFS CY2026
Medicare Non-Facility Rate
$662
Office/clinic setting
Hospital Outpatient
$2
OPPS rate
Surgery Center (ASC)
$1
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
3.88
Work RVU
2.47
Facility PE RVU
0.99
Malpractice RVU
19.82
Total RVU
Frequently Asked Questions
How much does Expl pentrg wnd abd/flnk/bk cost?
The Medicare facility rate is $245. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $2. Ambulatory surgery center rate: $1.
How much does Expl pentrg wnd abd/flnk/bk 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 $245.