Price Checker / CPT 11604
How much does Exc Tr-ext Mal+marg 3.1-4 Cm cost?
CPT 11604 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is about 2.3x the fair price. You have grounds to ask for a reduction.
Fair price
$1,050–$1,200
What this should cost
With insurance
~$139,600
Typical out-of-pocket
Overcharged if over
$1,500
Push back above this
The average hospital charge of $2,664 is $1,514 over the fair price (about 2.3x the fair rate).
What hospitals charge for Exc Tr-ext Mal+marg 3.1-4 Cm
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Edgerton Hospital and Health Services EDGERTON, WI | $3,305 | $2,413 | 963% |
| EHHS Milton Clinic , WI | $3,305 | $2,413 | 963% |
| EHHS Milton Clinic Medicare , WI | $2,818 | $2,057 | 806% |
| Meritus Medical Center, Inc. HAGERSTOWN, MD | $2,161 | — | 595% |
| Frederick Health Hospital FREDERICK, MD | $1,732 | — | 457% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Exc Tr-ext Mal+marg 3.1-4 Cm
CPT code 11604 refers to exc tr-ext mal+marg 3.1-4 cm (billing description: "Exc tr-ext mal+marg 3.1-4 cm"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $181 in a facility (hospital or surgery center) and $311 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.