CPT 11105 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • GC - Service performed by resident under supervision |
| Complexity Level | Low |
National average reimbursement for CPT 11105 by major payers:
$68.27
$79.16
$77.25
$109.72
| 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 11105 | ||||||
United | 11105 | $541.00 | 1679523351 - SURGERY CENTER OF PORT CHARLOTTE LTD | 201327093 - (FL) SURGERY CENTER OF PORT CHARLOTTE LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $1020.00 | 1770252868 - STONESPRINGS SURGICENTER, LLC | 812929320 - (VA) STONESPRINGS SURGICENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $500.00 | 1215410592 - ALLIANCE SURGERY CENTER AT WOODSTOCK, LLC | 830957221 - (GA) ALLIANCE SURGERY CENTER AT WOODSTOCK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $92.00 | 1134300080 - METAIRIE LA ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND THERAPEUTIC CENTER-METAIRIE | 205904530 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $532.00 | 1568583896 - EASTERN ORANGE AMBULATORY SURGERY CENTER, LLC | 205350007 - (NY) EASTERN ORANGE ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $574.00 | 1245263292 - CHATTANOOGA PAIN MANAGEMENT CENTER LLC, CHATTANOOGA PAIN SURGERY CENTER | 320121593 - (TN) CHATTANOOGA PAIN MANAGEMENT | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $1109.00 | 1962505354 - PROVIDENCE HEALTH SERVICES OF WACO, PROVIDENCE HEALTH CENTER | 741109636 - (TX) ASCENSION PROVIDENCE | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $339.00 | 1528021573 - SUMMIT SURGERY CENTER LP | 621777535 - (TN) SUMMIT SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $159.00 | 1447442348 - TIMOTHY P. CAREY M.D. INC. P.S. | 910870414 - (WA) TIMOTHY P CAREY MD INC PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $312.00 | 1306013925 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $1394.00 | 1306472063 - THE EMORY CLINIC INC, EMORY ENDOSCOPY CENTER AT DECATUR | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $85.00 | 1629094917 - ANNAPOLIS ENT SURGICAL CENTER, LLC | 522337616 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $1020.00 | 1477516979 - FAIRFAX SURGICAL CENTER, L.P. | 621861640 - (VA) FAIRFAX SURGICAL CENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $240.00 | 1952353187 - MCKENZIE SURGERY CENTER LP | 621600267 - (OR) MCKENZIE SURGERY CENTER LP | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11105 | $455.00 | 1972556942 - CHERRY HILL WOMEN'S CENTER, INC. | 232068660 - (NJ) CHERRY HILL WOMENS CENTER INC | NJ | 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 11105 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11105 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 11105 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 |
|---|---|---|
| 11102-CPT | Low | Tangential Biopsy Of Skin (Eg, Shave, Scoop, Saucerize, Curette); Single Lesion |
| 11103-CPT | Low | Tangential Biopsy Of Skin (Eg Shave Scoop Saucerize Curette); Each Separate/Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
| 11104-CPT | Low | Punch Biopsy Of Skin (Including Simple Closure When Performed); Single Lesion |
| 11105-CPT | Low | Punch Biopsy Of Skin (Including Simple Closure When Performed); Each Separate/ Additional Lesion (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 11105. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11105 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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