CPT 11106 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 • AG - Primary physician |
| Complexity Level | Low |
National average reimbursement for CPT 11106 by major payers:
$169.49
$197.08
$198.08
$265.22
| 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 11106 | ||||||
United | 11106 | $1000.00 | 1003842626 - AMBULATORY CENTER FOR ENDOSCOPY, LLC | 200064962 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $1139.00 | 1861766016 - HAYS SURGERY CENTER, LLC | 274579547 - (TX) HAYS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $420.00 | 1467472688 - WEST CLINIC ASTC, WEST CLINIC, PC | 621526296 - THE WEST CLINIC, PLLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $730.00 | 1467415513 - LAS VEGAS SURGICARE LTD | 880244070 - (NV) LAS VEGAS SURGICARE LTD | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $636.00 | 1538122569 - CENTENNIAL SURGERY CENTER LP | 621624530 - (TN) CENTENNIAL SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $410.00 | 1275231466 - ADVANCED JOINT AND SPINE INSTITUTE-ORLANDO, LLC | 872644888 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $967.00 | 1720530405 - GRAND RAPIDS SURGICAL SUITES LLC | 811321919 - (MI) GRAND RAPIDS SURGICAL SUITES, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $385.00 | 1871841544 - SPALDING ENDOSCOPY CENTER, LLC | 453051061 - (GA) SPALDING ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $350.00 | 1386833044 - THE POTTSVILLE PA ENDOSCOPY ASC LP, SCHUYLKILL ENDOSCOPY CENTER | 260303896 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $893.00 | 1811001860 - THE OUTPATIENT CENTER, LLC, THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | 650440864 - (FL) THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $3148.00 | 1740318153 - PLAZA SURGERY CENTER, L.P., PLAZA SURGERY CENTER | 770573567 - (CA) PLAZA SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $450.00 | 1881875227 - SKIN & MOHS SURGERY CENTER, LLC | 431823843 - SKIN MOHS SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $271.00 | 1073079596 - PREMIER GASTROENTEROLOGY ASSOCIATES PLLC, PREMIER SURGERY CENTER | 824134212 - (AR) PREMIER GASTROENTEROLOGY ASSOCIATES, PLLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $550.00 | 1841759040 - BEAVER VALLEY AMBULATORY SURGERY CENTER, LLC | 822918272 - (PA) BEAVER VALLEY AMBULATORY SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11106 | $390.00 | 1073509733 - WEST PLAINS SURGERY CENTER LLC | 320093110 - (MO) WEST PLAINS AMBULATORY SURGERY CENT | MO | 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 11106 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11106 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 11106 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 |
| 11106-CPT | Low | Incisional Biopsy Of Skin (Eg Wedge) (Including Simple Closure When Performed); Single Lesion |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11106. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11106 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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