CPT 11047 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 • 99 - Other POS |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
National average reimbursement for CPT 11047 by major payers:
$140.55
$151.87
$151.57
$200.61
| 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 11047 | ||||||
United | 11047 | $527.59 | 1609040443 - KATHLEEN SIMPSON | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Cardiology Physician (2080P0202X) |
United | 11047 | $274.42 | 1457663163 - JUSTIN RICHARDSON | 540620889 - INOVA HEALTH CARE SERVICES | CO | Surgery Physician (208600000X) |
United | 11047 | $156.00 | 1902849227 - EYE SURGERY CENTER, LLC | 371221499 - (IL) EYECARE MANAGEMENT, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11047 | $167.00 | 1013425933 - REX SURGERY CENTER OF WAKEFIELD, LLC | 465511168 - (NC) REX SURGERY CENTER OF WAKEFIELD LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11047 | $527.59 | 1790170439 - LAURIE HALMO | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatrics Physician (208000000X) |
United | 11047 | $183.57 | 1295091908 - ASHLEY DAVIS | 840744042 - (CO) COLORADO SURGICAL SERVICE P.C. | AL | Surgery Physician (208600000X) |
United | 11047 | $1202.00 | 1881628725 - CATHOLIC HEALTH INITIATIVES COLORADO, <UNAVAIL> | 840405257 - CATHOLIC HEALTH INITIATIVES COLORADO | CO | Specialist (174400000X) |
United | 11047 | $1831.00 | 1952331092 - MEMORIAL HERMANN SURGERY CENTER SUGAR LAND LLP | 203233617 - (TX) MEMORIAL HERMANN SURGERY CENTER SUGAR LAND LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11047 | $172.83 | 1871538652 - ANDREW DABBS | 646000892 | AK | Surgery Physician (208600000X) |
United | 11047 | $179.63 | 1356583991 - JOHANNE PYTHON | 841520625 - (CO) OB/GYN AFFILIATES | CO | Specialist (174400000X) |
United | 11047 | $144.72 | 1700974102 - ROBERT J. WESTER, M.D.,P.C. | 841116276 - (CO) ROBERT J. WESTER, M.D., P.C. | CO | Specialist (174400000X) |
United | 11047 | $109.79 | 1417032129 - GAIL MOLLOY | 841288940 - (CO) PHYSICAL THERAPY INDUSTRIAL SERVICES PC | CO | Specialist (174400000X) |
United | 11047 | $369.45 | 1457772162 - TRAUMAONE, PLLC | 464261978 - (CO) TRAUMAONE PLLC | CO | Trauma Surgery Physician (2086S0127X) |
United | 11047 | $176.50 | 1730220278 - SANDEEP VIJAN | 846027322 - (CO) HUERFANO COUNTY HOSPITAL DISTRICT | CO | Surgery Physician (208600000X) |
United | 11047 | $406.41 | 1407065188 - BENJAMIN STEINBERG | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | UT | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
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 11047 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11047 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 11047 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 |
| 11047 | Low | Debridement, Bone (Includes Epidermis, Dermis, Subcutaneous Tissue, Muscle And/Or Fascia, 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 11047. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11047 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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