Price Checker / CPT 12031
How much does Intmd Rpr S/a/t/ext 2.5 Cm/< cost?
CPT 12031 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 10x the fair price — among the most extreme markups. Dispute this.
Fair price
$570–$670
What this should cost
With insurance
~$91,800
Typical out-of-pocket
Overcharged if over
$840
Push back above this
The average hospital charge of $6,398 is $5,778 over the fair price (about 10x the fair rate).
What hospitals charge for Intmd Rpr S/a/t/ext 2.5 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 |
|---|---|---|---|
| Franciscan Health Orthopedic-Carmel , IN | $31,961 | $8,406 | 12199% |
| Big Sandy Medical Center Big Sandy, MT | $4,000 | — | 1424% |
| Morton County Health System Elkhart, KS | $4,362 | — | 1411% |
| Meritus Medical Center, Inc. HAGERSTOWN, MD | $1,296 | — | 399% |
| Edgerton Hospital and Health Services EDGERTON, WI | $1,198 | $875 | 361% |
| EHHS Milton Clinic , WI | $1,198 | $875 | 361% |
| EHHS Milton Clinic Medicare , WI | $770 | $562 | 196% |
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 Intmd Rpr S/a/t/ext 2.5 Cm/<
CPT code 12031 refers to intmd rpr s/a/t/ext 2.5 cm/< (billing description: "Intmd rpr s/a/t/ext 2.5 cm/<"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $133 in a facility (hospital or surgery center) and $260 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.