CPT 21080 Surgery - Musculoskeletal

Impres&prep def obt prosth Cost

Body System: Musculoskeletal

Medicare Facility Rate
$1,163
CMS PFS CY2026
Medicare Non-Facility Rate
$1,730
Office/clinic setting
Hospital Outpatient
$3
OPPS rate
Surgery Center (ASC)
$821
ASC rate

Relative Value Units (RVUs)

Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)

24.43
Work RVU
7.48
Facility PE RVU
2.91
Malpractice RVU
51.79
Total RVU

Frequently Asked Questions

How much does Impres&prep def obt prosth cost?

The Medicare facility rate is $1,163. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $3. Ambulatory surgery center rate: $821.

How much does Impres&prep def obt prosth 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 $1,163.

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