CPT 23616 Surgery - Musculoskeletal
Optx prx hmrl fx fix rpr rpl Cost
Body System: Musculoskeletal
Medicare Facility Rate
$1,122
CMS PFS CY2026
Medicare Non-Facility Rate
$1,122
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
17.91
Work RVU
11.97
Facility PE RVU
3.70
Malpractice RVU
33.58
Total RVU
Frequently Asked Questions
How much does Optx prx hmrl fx fix rpr rpl cost?
The Medicare facility rate is $1,122. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Optx prx hmrl fx fix rpr rpl 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 $1,122.