CPT 11010 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 11010 by major payers:
$520.78
$602.67
$603.49
$731.95
| 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 11010 | ||||||
United | 11010 | $525.00 | 1215981113 - ENGLEWOOD SURGERY CENTER, LLC | 421670784 - (CO) ENGLEWOOD SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $1158.00 | 1730713439 - FLORIDA SPRINGS SURGERY CENTER LLC | 832895293 - (FL) FLORIDA SPRINGS SURGERY CENTER L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $429.00 | 1265679674 - GEORGIA UROLOGY FAYETTE ASC | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $700.00 | 1275510141 - NEOSPINE PUYALLUP SPINE CENTER, LLC, MICROSURGICAL SPINE CENTER | 203395071 - (WA) NEOSPINE PUYALLUP SPINE CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $450.00 | 1447472659 - BROCKTON ENDOSCOPY SURGERY CENTER LP | 61706315 - (CA) BROCKTON ENDOSCOPY SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $350.00 | 1154787117 - THE PENNSYLVANIA SURGERY AND LASER CENTER LLC | 300826026 - (PA) PENNSYLVANIA SURGERY AND LASER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $967.00 | 1376155440 - COLORADO UROLOGIC SURGERY CENTER LLC | 851926897 - (CO) COLORADO UROLOGIC SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $1158.00 | 1811447246 - VIRGIL ENDOSCOPY CENTER LLC | 813981623 - (CA) VIRGIL ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $843.11 | 1316407596 - VICKY SANDHU | 350593390 - DEACONESS HOSPITAL INC | CA | Hospitalist Physician (208M00000X) |
United | 11010 | $204.00 | 1245868488 - AVON SURGERY CENTER, LLC | 823987550 - (OH) AVON SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $2777.00 | 1497244149 - HOSPITAL FOR SPECIAL SURGERY WEST SIDE AMBULATORY SURGERY CENTER, LLC, HSS WEST SIDE ASC, LLC | 814351390 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $534.00 | 1821047499 - RIVERSIDE SURGERY CENTER, INC. | 680400319 - (CA) RIVERSIDE SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $967.00 | 1750823886 - LAKE ENDOSCOPY CENTER, LLC | 814225104 - (FL) LAKE ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $445.00 | 1194291401 - AFFILIATED PHYSICIANS & SURGEONS, LTD | 860495569 - (AZ) AFFILIATED PHYSICIANS SURGEONS LTD | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11010 | $843.11 | 1659351419 - JASON MECKLER | 350593390 - DEACONESS HOSPITAL INC | IN | Neurology Physician (2084N0400X) |
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 11010 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11010 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 11010 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 |
|---|---|---|
| 11010 | Moderate | Debridement Including Removal Of Foreign Material At The Site Of An Open Fracture And/Or An Open Dislocation (Eg, Excis Debridement); Skin And Sub-Q Tissues (Revision 2011) |
| 11011 | Moderate | Debridement Including Removal Of Foreign Material At The Site Of An Open Fracture And/Or An Open Dislocation (Eg, Excisional Debridement); Skin, Subcutaneous Tissue, Muscle Fascia, And Muscle |
| 11012 | Moderate | Debridement Including Removal Of Foreign Material At The Site Of An Open Fracture And/Or An Open Dislocation (Eg, Excisional Debridement); Skin, Subcutaneous Tissue, Muscle Fascia, Muscle, And Bone |
| 11042 | Low | Debridement; Subcutaneous Tissue (Includes Epidermis And Dermis If Performed); First Each 20 Sq Cm Or Less |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11010. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11010 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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