CPT 11045 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 | • 22 - On Campus Outpatient Hospital • 99 - Other POS |
| Common Modifiers | • None • 59 - Distinct Procedural Service • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Moderate |
National average reimbursement for CPT 11045 by major payers:
$47.93
$51.44
$51.16
$75.47
| 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 11045 | ||||||
United | 11045 | $68.72 | 1982947321 - DANIEL WILLNER | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | NC | Emergency Medicine Physician (207P00000X) |
United | 11045 | $137.00 | 1881972800 - GENEVIEVE MOYER | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | MO | Hematology & Oncology Physician (207RH0003X) |
United | 11045 | $68.72 | 1396858650 - STEFAN PETTINE | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Surgery Physician (208600000X) |
United | 11045 | $68.72 | 1275503120 - ERIC STEVENS | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Pulmonary Disease Physician (207RP1001X) |
United | 11045 | $68.72 | 1790064285 - REBEKAH ZALUZEC | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Plastic and Reconstructive Surgery Physician (2086S0122X) |
United | 11045 | $109.51 | 1528133394 - CHERYL ENGLISH | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Adult Health Nurse Practitioner (363LA2200X) |
United | 11045 | $68.72 | 1568728491 - ALYSSA NASH | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Internal Medicine Physician (207R00000X) |
United | 11045 | $79.45 | 1366754616 - DARNELL BROWN | 850105601 - PRESBYTERIAN HEALTHCARE SERVICES | NH | Surgery Physician (208600000X) |
United | 11045 | $111.66 | 1043353840 - KATJA KISELJAK-VASSILIADES | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Endocrinology, Diabetes & Metabolism Physician (207RE0101X) |
United | 11045 | $703.00 | 1811973639 - SUMMIT ORTHOPEDICS LTD, DBA LANDMARK SURGERY CENTER | 411762331 - SUMMIT ORTHOPEDICS, LTD. | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11045 | $42.75 | 1447267018 - STEPHEN BARNES | 113708963 - (CO) FRONT RANGE SURGICAL SERVICES PC | CO | Surgery Physician (208600000X) |
United | 11045 | $68.72 | 1578856159 - JONATHAN DIAZ | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | LA | Neurology Physician (2084N0400X) |
United | 11045 | $574.00 | 1639134505 - PUEBLO AMBULATORY SURGERY CENTER LLC | 621488737 - (CO) PUEBLO AMBULATORY SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11045 | $200.00 | 1851475461 - TEXOMA VALLEY SURGERY CENTER LP | 752917581 - (TX) TEXOMA VALLEY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11045 | $906.00 | 1245749258 - FOCUS HAND SURGICENTER LLC, FOCUS HAND AND ARM SURGERY CENTER | 822523843 | CO | 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 11045 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11045 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 11045 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) |
| 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 |
| 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 11045. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11045 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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