CPT 11107 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 • 76 - Repeat procedure by same physician |
| Complexity Level | Moderate |
National average reimbursement for CPT 11107 by major payers:
$82.67
$93.67
$90.59
$128.79
| 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 11107 | ||||||
United | 11107 | $125.38 | 1649264383 - VENKATESH MADADI | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
United | 11107 | $50.00 | 1609955517 - KNOXVILLE EYE SURGERY CENTER LLC, TENNESSEE VALLEY EYE CENTER | 621680280 - (TN) KNOXVILLE EYE SURGERY CENTER, LLC; DBA TENNESSEE VALLEY EYE CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $521.00 | 1154460525 - VIRGINIA MASON MEDICAL CENTER, VIRGINIA MASON LYNNWOOD ASC | 910565539 - (WA) VIRGINIA MASON MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $104.00 | 1548359037 - SURGERY CENTER OF BRANSON, SURGERY CENTER OF BRANSON LLC | 680627781 - (MO) SURGERY CENTER OF BRANSON | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $555.00 | 1568867075 - POTOMAC VIEW SURGERY CENTER, LLC | 471352116 - (MD) POTOMAC VIEW SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $79.00 | 1205373057 - BAY AREA ASC LLC, AZURA SURGERY CENTER HOUSTON | 814821022 - (TX) BAY AREA ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $803.00 | 1003138736 - NEWPORT SURGICAL PARTNERS LLC, NEWPORT PLAZA SURGICAL CENTER | 392060266 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $85.00 | 1760658256 - HARVARD SURGERY CENTER LLC | 208147301 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $140.00 | 1619517539 - MOUNTAIN WEST DERM | 813253496 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $216.00 | 1144312075 - GATEWAY AMBULATORY SURGERY CENTER LLC, GATEWAY SURGERY CENTER | 202106989 - (NC) GATEWAY AMBULATORY SURGERY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $1394.00 | 1508974353 - SOUTHLAKE AMBULATORY SURGERY CENTER, LLLP, SPIVEY STATION SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $574.00 | 1548784556 - NORTH ATLANTIC SURGICAL SUITES, LLC | 821540859 - (NH) NORTH ATLANTIC SURGICAL SUITES, LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $120.00 | 1093287302 - WHEELING HOSPITAL AMBULATORY SURGERY CENTER LLC | 832914078 - (OH) WHEELING HOSPITAL AMBULATORY SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $566.00 | 1366982845 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY | 384016302 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11107 | $688.00 | 1205945243 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | 593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | FL | 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 11107 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11107 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 11107 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 | Low | Tangential Biopsy Of Skin (Eg, Shave, Scoop, Saucerize, Curette); Single Lesion |
| 11103 | Low | Tangential Biopsy Of Skin (Eg Shave Scoop Saucerize Curette); Each Separate/Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
| 11104 | Low | Punch Biopsy Of Skin (Including Simple Closure When Performed); Single Lesion |
| 11107 | Low | Incisional Biopsy Of Skin (Eg Wedge) (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 11107. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11107 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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