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See a sample rate comparisonCPT 11055 Fee Schedule
Last Verified: October 2026
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.
Paring Or Cutting Of Benign Hy, Paring Or Cutting Of Benign Hyperkeratotic Lesion (Eg Corn Or Callus) Single Lesion Paring Or Cutting Of Benign Hyperkeratotic Lesion (Eg Corn
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 11 - Office None |
| Common Modifiers | None Q8 - Two Class B Findings Q9 - One Class B and Two Class C Findings |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 11055 |
| Medicaid Fee Schedule | View Medicaid rates for 11055 |
National average reimbursement for CPT 11055 by major payers:
$67.07
$70.60
$78.40
$99.15
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CPT 11055
5 of 25 sample ratesHigher to lower in this preview
Litchfield Hills Surgery Center
$1,543.00Published rateSpring Hill Surgery Center, LLC
Spring Hill Surgery Center LLC
$678.00Published rateGastroenterology Associates, LLC, Gastroenterology Associates Endoscopy Center
Gastroenterology Associates PLLC
$531.00Published rateAkdhc Surgery Center, LLC
$245.00Published rateAmbulatory Surgery Center At Indiana Eye Clinic LLC
$90.00Published rate
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See a sample payer proposalCPT 11055 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11055 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 11055 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 |
|---|---|---|
| 11042-CPT | Low | Debridement Subcutaneous Tiss, Debridement Subcutaneous Tissue (Includes Epidermis And Dermis If Performed) First 20 Sq Cm Or Less |
| 11055-CPT | Low | Paring Or Cutting Of Benign Hy, Paring Or Cutting Of Benign Hyperkeratotic Lesion (Eg Corn Or Callus) Single Lesion Paring Or Cutting Of Benign Hyperkeratotic Lesion (Eg Corn |
| 11056-CPT | Low | Paring Or Cutting Of Benign Hy, Paring Or Cutting Of Benign Hyperkeratotic Lesion (Eg Corn Or Callus) Two To Four Lesions Paring Or Cutting Of Benign Hyperkeratotic Lesion (Eg Corn |
| 11057-CPT | Low | Paring Or Cutting Of Benign Hy, Paring Or Cutting Of Benign Hyperkeratotic Lesion (Eg Corn Or Callus) More Than Four Lesions Paring Or Cutting Of Benign Hyperkeratotic Lesion (Egcorn |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11055. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11055 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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