CPT 56442 Surgery - Female Genital
Hymenotomy Cost
Body System: Reproductive
Medicare Facility Rate
$44
CMS PFS CY2026
Medicare Non-Facility Rate
$44
Office/clinic setting
Hospital Outpatient
$3
OPPS rate
Surgery Center (ASC)
$1
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.66
Work RVU
0.53
Facility PE RVU
0.12
Malpractice RVU
1.31
Total RVU
Frequently Asked Questions
How much does Hymenotomy cost?
The Medicare facility rate is $44. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $3. Ambulatory surgery center rate: $1.
How much does Hymenotomy 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 $44.