CPT 49505 Surgery - Digestive
Prp i/hern init reduc >5 yr Cost
Body System: Digestive
Medicare Facility Rate
$508
CMS PFS CY2026
Medicare Non-Facility Rate
$508
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
7.76
Work RVU
5.40
Facility PE RVU
2.05
Malpractice RVU
15.21
Total RVU
Frequently Asked Questions
How much does Prp i/hern init reduc >5 yr cost?
The Medicare facility rate is $508. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Prp i/hern init reduc >5 yr 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 $508.