CPT 11057 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 | • 11 - Office • None |
| Common Modifiers | • None • Q8 - Two Class B Findings • 59 - Distinct Procedural Service |
| Complexity Level | Low |
National average reimbursement for CPT 11057 by major payers:
$95.03
$95.39
$100.76
$134.85
| 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 11057 | ||||||
United | 11057 | $100.00 | 1750313144 - AMBULATORY SURGICAL CARE, LLC | 593082994 - (FL) AMBULATORY SURGICAL CARE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $112.00 | 1669540118 - STEVENS KIM MD AND STEPHEN LIN MD MEDICAL GROUP INC, VALLEY LASER SURGERY CENTER, INC. | 203111961 - (CA) STEVENS KIM MD AND STEPHEN LIN MD MEDICAL GROUP INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $155.00 | 1790744175 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, PUYALLUP ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $150.00 | 1881193183 - SOUTHSIDE SPECIALTY SURGICAL CENTER LLC | 823920550 - (TX) SOUTHSIDE SPECIALTY SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $142.00 | 1508846122 - HEALTH & WELLNESS SURGERY CENTER, TOWER SURGERY CENTER | 562437008 - (CA) HEALTH WELLNESS SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $702.00 | 1275886319 - SURGERY CENTER OF BAY AREA HOUSTON, LLC | 320383244 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $574.00 | 1467601625 - MNH GI SURGICAL CENTER LLC, MNH SURGICAL CENTER | 263094275 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $200.00 | 1356954648 - ASC OF THE HEART INSTITUTE | 823433427 - (NM) ASC OF THE HEART INSTITUTE | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $275.00 | 1366065674 - SOUTH DENVER SURGICAL SERVICES LLC, SOUTH DENVER UROLOGY CENTER | 850873977 - (CO) SOUTH DENVER SURGICAL SERVICES LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $169.00 | 1275821746 - OREGON EAR NOSE AND THROAT SURGERY | 452437880 - (OR) OREGON EAR NOSE AND THROAT SURGERY | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $205.00 | 1780959007 - COLUMBIA RIVER SURGERY CENTER LLC | 452481484 - (OR) COLUMBIA RIVER SURGERY CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $425.00 | 1376538876 - THE ENDOSCOPY CENTER OF BRISTOL | 621727371 - (TN) THE ENDOSCOPY CENTER OF BRISTOL | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $788.00 | 1053585125 - BJOSC, LLC, BONE & JOINT SURGERY CENTER | 300391378 - BJOSC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $1115.00 | 1689666596 - MENOMONEE FALLS AMBULATORY SURGERY CENTER, LLC | 391745697 - (WI) MENOMONEE FALLS AMBULATORY SURGERY CENTER | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11057 | $1446.00 | 1023420577 - TEXAS ENDOSCOPY CENTERS, LLC, TEXAS ENDOSCOPY | 470985876 | TX | 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 11057 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11057 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 11057 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 Eczematous Or Infected Skin; Each Additional 10% Of The Body Surface, Or Part Thereof (List Separately In Addition To Code For Primary Procedure) |
| 11042-CPT | Low | Debridement; Subcutaneous Tissue (Includes Epidermis And Dermis If Performed); First Each 20 Sq Cm Or Less |
| 11043-CPT | Moderate | Debridement; Muscle An/Or Fascia (Includes Epidermis Dermis And Subcutaneous Tissue Muscle And/Or Fascia If Perfomred); First 20 Sq Cm Or Less |
| 11057-CPT | Low | Paring/Cutting Benign Hyperkeratotic Lesion (Eg Corn/Callus); > 4 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11057. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11057 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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