CPT 21445 Surgery - Musculoskeletal
Optx mndblr/max alv ridge fx Cost
Body System: Musculoskeletal
Medicare Facility Rate
$567
CMS PFS CY2026
Medicare Non-Facility Rate
$753
Office/clinic setting
Hospital Outpatient
$6
OPPS rate
Surgery Center (ASC)
$3
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
6.10
Work RVU
10.18
Facility PE RVU
0.69
Malpractice RVU
22.55
Total RVU
Frequently Asked Questions
How much does Optx mndblr/max alv ridge fx cost?
The Medicare facility rate is $567. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $6. Ambulatory surgery center rate: $3.
How much does Optx mndblr/max alv ridge fx 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 $567.