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Revenue Code (RC) 0511 Fee Schedule

Last Verified: November 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Chronic pain center

Key FactDetail
Service Type

Clinic

Common Place of Service
Common Modifiers
Complexity LevelModerate

National average reimbursement for Revenue Code 0511 by major payers:

bcbs

$43.75

uhc

$114.00

aetna

$233.32

cigna

$111.00

Preview provider-level rates for...
For billing codeRC 0511
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for RC 0511

United
0511$72.001407990088 - PMC HOSPITAL, LLC, ST. LUKE'S PATIENTS MEDICAL CENTER273280598 - (TX) PMC HOSPITAL LLCTXGeneral Acute Care Hospital (282N00000X)
United
0511$351.001740263367 - SARASOTA COUNTY PUBLIC HOSPITAL DISTRICT, SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER596012500 - (FL) SARASOTA COUNTY PUBLIC HOSPITAL DISTRICTFLSkilled Nursing Facility (314000000X)
United
0511$74.001710314141 - ST. LUKES HOSPITAL AT THE VINTAGE263734606 - (TX) ST LUKES HOSPITAL AT THE VINTAGETXGeneral Acute Care Hospital (282N00000X)
United
0511$22.001154618742 - VHS HARLINGEN HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER452662980TXGeneral Acute Care Hospital (282N00000X)
United
0511$82.001184622847 - CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER741161938 - CHI ST LUKES HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTERTXGeneral Acute Care Hospital (282N00000X)
United
0511$74.001659559573 - ST LUKES COMMUNITY DEVELOPMENT CORPORATION, ST LUKES SUGAR LAND HOSPITAL261947374 - (TX) ST LUKES COMMUNITY DEVELOPMENT CORPORATIONTXGeneral Acute Care Hospital (282N00000X)
United
0511$77.001942294939 - ST JOSEPH REGIONAL HEALTH CENTER, ST JOSEPH AMBULATORY SURGERY741282696 - ST JOSEPH REGIONAL HEALTH CENTERTXGeneral Acute Care Hospital (282N00000X)
United
0511$74.001942208616 - ST. LUKE'S COMMUNITY HEALTH SERVICES, ST. LUKE'S THE WOODLANDS HOSPITAL760536234 - (TX) ST LUKES COMMUNITY HEALTH SERVICESTXGeneral Acute Care Hospital (282N00000X)
United
0511$74.001710314141 - ST. LUKES HOSPITAL AT THE VINTAGE263734606 - (TX) ST LUKES HOSPITAL AT THE VINTAGETXGeneral Acute Care Hospital (282N00000X)
United
0511$66.001558432542 - PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA, JACKSON MEMORIAL PERDUE MEDICAL CENTER591713947 - (FL) PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FLORIDAFLSkilled Nursing Facility (314000000X)
United
0511$77.001942294939 - ST JOSEPH REGIONAL HEALTH CENTER, ST JOSEPH AMBULATORY SURGERY741282696 - ST JOSEPH REGIONAL HEALTH CENTERTXGeneral Acute Care Hospital (282N00000X)
United
0511$22.001457994188 - VHS HARLINGEN HOSPITAL COMPANY, LLC, VALLEY BAPTIST MICRO-HOSPITAL WESLACO452662980TXGeneral Acute Care Hospital (282N00000X)
United
0511$66.001134116320 - PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA, JACKSON MEMORIAL LONG TERM CARE CENTER591713947 - (FL) PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FLORIDAFLSkilled Nursing Facility (314000000X)
United
0511$74.001407990088 - PMC HOSPITAL, LLC, ST. LUKE'S PATIENTS MEDICAL CENTER273280598 - (TX) PMC HOSPITAL LLCTXGeneral Acute Care Hospital (282N00000X)
United
0511$21.001457994188 - VHS HARLINGEN HOSPITAL COMPANY, LLC, VALLEY BAPTIST MICRO-HOSPITAL WESLACO452662980TXGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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Revenue Code 0511 vs. Other Clinic Codes

The Revenue Code 0511 code is part of the Clinic services . It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The Revenue Code 0511 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
0510HighGeneral
0511LowChronic pain center
0512HighDental clinic

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including Revenue Code 0511. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 0511 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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Medicare Reimbursement Lookup Tool

Medicare localities are geographic regions used to adjust reimbursement rates based on local costs. Rates vary by locality to reflect differences in wages, rent, and other expenses. Sign up to see commercial rates (United/BCBS/Cigna/Aetna)

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YearBilling CodeLocalityNon-Facility FeeFacility Fee