CPT 11960 Surgery - Integumentary

How Much Does Insert Tissue Expander(s) Cost?

Also known as: Insert tissue expander(s) (CPT 11960)

Insertion of a tissue expander under the skin to gradually stretch tissue for later reconstruction.

The total estimated cost of Insert Tissue Expander(s) (CPT 11960) is $2,389 to $3,883, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $948.

Total Estimated Cost of Care

$2,389 — $3,883

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$948
Hospital Facility Fee
$1,897
Anesthesia (est.)
$142
Important: The physician fee of $948 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$948
Physician component only — CMS PFS 2026

Patient Guide: Insert Tissue Expander(s)

What you need to know before your appointment

What to Expect

Under anesthesia, the surgeon creates a pocket under the skin and places a deflated balloon-like device. Over weeks, the device is gradually filled with saline in the office to stretch the overlying skin.

How Long Does It Take?

1-2 hours for initial surgery; serial office fills over weeks

Common Reasons Doctors Order This

Breast reconstruction after mastectomy, scalp reconstruction, creating skin for burn reconstruction

How to Prepare

Fast before surgery. Plan for multiple office visits for saline fills. The expansion phase typically lasts 2-3 months.

Procedures Commonly Done Together

These procedures are frequently performed alongside Insert tissue expander(s)

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How to Reduce Your Cost for Insert tissue expander(s)

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

11.20
Work RVU
15.21
Practice Expense RVU
1.98
Malpractice RVU
28.39
Total RVU

Payment = Total RVU (28.39) x CF ($33.40) = $948

Frequently Asked Questions

How much does Insert tissue expander(s) cost?

The Medicare facility rate for Insert tissue expander(s) is $948. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Insert tissue expander(s) cost without insurance?

Without insurance, the cost of Insert tissue expander(s) can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Insert tissue expander(s)?

Most commercial health insurance plans and Medicare cover Insert tissue expander(s) when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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