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 | Debridement Procedures on the Skin Surgical Procedures on the Skin, Subcutaneous and Accessory Structures |
| 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 | Low |
| Medicare Fee Schedule | View Medicare rates for 11045 |
National average reimbursement for CPT 11045 by major payers:
$47.93
$51.44
$51.16
$51.06
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 11045 | $51.29 | 1518974708 - DORU GEORGESCU | 841032396 - (CO) CENTER OF SURGICAL SPECIALISTS PC | CO | Surgery Physician (208600000X) |
United | 11045 | $111.66 | 1063040277 - NEHA ALI | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Obstetrics & Gynecology Physician (207V00000X) |
United | 11045 | $42.77 | 1447296710 - ANDREA KAISER | 840881853 - (CO) SANGRE DE CRISTO SURGICAL ASSOCIATES, PC | CO | Surgery Physician (208600000X) |
United | 11045 | $50.40 | 1053503599 - LISA SCHLITZKUS | 841043351 - (CO) COLORADO VISITING NURSE ASSOCIATION | CO | Surgical Critical Care Physician (2086S0102X) |
United | 11045 | $109.51 | 1164878799 - NATHAN COFFMAN | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | AZ | Hospitalist Physician (208M00000X) |
United | 11045 | $52.65 | 1215271374 - MATTHEW A METZ MD PC, <UNAVAIL> | 264180557 - (CO) MATTHEW A. METZ MD PC | CO | Surgery Physician (208600000X) |
United | 11045 | $77.00 | 1790742328 - SPRINGHILL SURGERY CENTER, LLC | 621712554 - (AR) SPRINGHILL SURGERY CENTER, LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11045 | $139.75 | 1427610617 - KATHERINE ALPOGIANIS | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Medical Physician Assistant (363AM0700X) |
United | 11045 | $30.79 | 1316029937 - JOHN BERSHOF | 841258487 - JOHN FOX BERSHOF MD PC | CO | Specialist (174400000X) |
United | 11045 | $109.51 | 1609222421 - JAMES FARRELL | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | NY | Orthopaedic Surgery of the Spine Physician (207XS0117X) |
United | 11045 | $174.38 | 1164715108 - ERIC MARABLE | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Anesthesiology Physician (207LP3000X) |
United | 11045 | $144.30 | 1114641974 - MARIAH MILLER | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Nurse Practitioner (363LP0200X) |
United | 11045 | $79.45 | 1366754616 - DARNELL BROWN | 850105601 - PRESBYTERIAN HEALTHCARE SERVICES | NH | Surgery Physician (208600000X) |
United | 11045 | $38.34 | 1790858520 - KIAN MODANLOU | 841505645 - SURGONE, P.C. | CO | Surgery Physician (208600000X) |
United | 11045 | $111.66 | 1043353840 - KATJA KISELJAK-VASSILIADES | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Endocrinology, Diabetes & Metabolism Physician (207RE0101X) |
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 Skin, Subcutaneous and Accessory Structures Codes
The CPT 11045 code is part of the Debridement Procedures on the Skin services used for Surgical Procedures on the Skin, Subcutaneous and Accessory Structures. 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-CPT | Low | Debridement Of Extensive Eczem, 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-CPT | Moderate | Debride Skin Musc At Fx Site, 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-CPT | Moderate | Deb Skin Bone At Fx Site, 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-CPT | Low | Dbrdmt Subq Tiss Each Addl, 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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