CPT 21470 Surgery - Musculoskeletal
Optx complicated mndblr fx Cost
Body System: Musculoskeletal
Medicare Facility Rate
$1,039
CMS PFS CY2026
Medicare Non-Facility Rate
$1,039
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)
17.10
Work RVU
11.46
Facility PE RVU
2.56
Malpractice RVU
31.12
Total RVU
Frequently Asked Questions
How much does Optx complicated mndblr fx cost?
The Medicare facility rate is $1,039. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $6. Ambulatory surgery center rate: $3.
How much does Optx complicated mndblr 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 $1,039.