CPT 11001 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 11 - Office • 50 - Federally Qualified Health Center • None |
| Common Modifiers | • None • 59 - Distinct Procedural Service • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 11001 by major payers:
$28.90
$29.50
$30.40
$41.33
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 11001 | ||||||
United | 11001 | $175.00 | 1730514027 - KY ADVANCED SURGICAL CENTER INC | 901005366 - (CA) KY ADVANCED SURGICAL CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $66.00 | 1952336521 - CASC AQUISITION INC, CAROLINA AMBULATORY SURGERY CENTER | 810576467 - (SC) CASC AQUISITION INC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $203.00 | 1508318411 - INTERVENTIONAL SPINE CENTER, LLC | 263161503 - (CA) INTERVENTIONAL SPINE CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $510.00 | 1689059222 - GOLDSTEP AMBULATORY SURGERY CENTER, LLC | 465647464 - (NY) GOLDSTEP AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $100.00 | 1972508174 - VILLAGE SURGICENTER, LIMITED PARTNERSHIP, VILLAGE SURGICENTER OF ERIE | 760555703 - (PA) VILLAGE SURGICENTER LIMITED PARTNERSHIP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $115.00 | 1487043386 - DENTAL SURGICENTER OF LOUISVILLE INC | 464672803 - (KY) DENTAL SURGICENTER | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $143.00 | 1588071575 - FOULK ROAD SURGERY CENTER | 510385184 - (DE) WILMINGTON AMBULATORY SURGICAL CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $2347.00 | 1356124309 - SAINT LUKE'S NORTH SURGERY CENTER, LLC | 920591506 - (MO) SAINT LUKES NORTH SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $574.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $116.00 | 1861485138 - DISCOVER EYE SURGERY CENTER, LLC, EYE SURGERY CENTER - THE CLIFFS | 431909100 - (MO) DISCOVER EYE SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $146.00 | 1497788277 - PACIFIC EYE SURGERY CENTER, PACIFIC SURGERY CENTER | 954200314 - (CA) PACIFIC EYE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $108.00 | 1851317614 - KENDALL POINTE SURGERY CENTER LLC | 364236445 - (IL) KENDALL POINTE SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $399.00 | 1568437820 - FLORIDA ENDOSCOPY AND SURGERY CENTER, LLC, FLORIDA ENDOSCOPY & SURGERY CENTER | 593622500 - (FL) FLORIDA ENDOSCOPY AND SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $80.00 | 1124296173 - TREASURE COAST SURGICAL CENTER INC | 260770428 - (FL) TREASURE COAST SURGICAL CENTER, INC. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11001 | $200.00 | 1184195877 - ALPINE SURGICENTER, LLC | 204038061 | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 11001 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11001 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. 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 CPT 11001 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.
| Code | Complexity | Description |
|---|---|---|
| 11001 | Low | Debridement Of Extensive Eczematous Or Infected Skin; Each Additional 10% Of The Body Surface, Or Part Thereof (List Separately In Addition To Code For Primary Procedure) |
| 11042 | Low | Debridement; Subcutaneous Tissue (Includes Epidermis And Dermis If Performed); First Each 20 Sq Cm Or Less |
| 11043 | Moderate | Debridement; Muscle An/Or Fascia (Includes Epidermis Dermis And Subcutaneous Tissue Muscle And/Or Fascia If Perfomred); First 20 Sq Cm Or Less |
| 11045 | Low | Debridement, Subcutaneous Tissue (Includes Epidermis And Dermis, If Performed); Each Additional 20 Sq Cm, Or Part Thereof (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11001. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11001 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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