CPT 96573 Other
Pdt dstr prmlg les phys/qhp Cost
Body System: General
Medicare Facility Rate
$217
CMS PFS CY2026
Medicare Non-Facility Rate
$217
Office/clinic setting
Hospital Outpatient
$205
OPPS rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.47
Work RVU
6.02
Facility PE RVU
0.02
Malpractice RVU
6.51
Total RVU
Frequently Asked Questions
How much does Pdt dstr prmlg les phys/qhp cost?
The Medicare facility rate is $217. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $205.
How much does Pdt dstr prmlg les phys/qhp 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 $217.