CPT 11200 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 • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 11200 by major payers:
$105.01
$109.67
$116.04
$147.18
| 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 11200 | ||||||
United | 11200 | $200.00 | 1417409285 - BEAUMONT ASC, LP, BEAUMONT HEART & VASCULAR SURGERY CENTER | 814050976 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11200 | $71.04 | 1912247297 - PAUL BRINTON | 350593390 - DEACONESS HOSPITAL INC | ID | Certified Registered Nurse Anesthetist (367500000X) |
United | 11200 | $135.00 | 1760518609 - NORTH POINT SURGERY CENTER, INC | 770557917 - (CA) NORTH POINT SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11200 | $136.00 | 1104899855 - SOUTHFIELD ENDOSCOPY ASC LLC, GASTROINTESTINAL ENDOSCOPY CENTER | 943421929 | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11200 | $65.00 | 1295851137 - PHYSICIANS SURGERY CENTER LLC | 200435814 - (AR) PHYSICIANS SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11200 | $71.15 | 1053361642 - DEACONESS HOSPITAL, INC. | 350593390 - DEACONESS HOSPITAL INC | IN | General Acute Care Hospital (282N00000X) |
United | 11200 | $916.00 | 1538769302 - SPINE SOLUTIONS OF GREEN BAY LLC | 853678180 - (WI) SPINE SOLUTIONS OF GREEN BAY LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11200 | $158.00 | 1437706140 - GEISINGER-HM JOINT VENTURE, LLC | 831871064 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11200 | $508.00 | 1386619682 - HUTCHINSON CLINIC, P.A., INC., HUTCHINSON CLINIC ENDOSCOPY CENTER | 480734011 - (KS) HUTCHINSON CLINIC, P.A. | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11200 | $500.00 | 1831368356 - VERMONT EYE SURGERY & LASER CENTER | 204872230 - (VT) VERMONT EYE SURGERY & LASER CENTER, LLC 401(K) PLAN | VT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11200 | $344.00 | 1497727093 - BARNET DULANEY PERKINS EYE CENTER, PC, AMERICAN VISION PARTNERS | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11200 | $91.00 | 1407828494 - INDEPENDENCE ASC LLC, THE ENDOSCOPY CENTER - EAST | 621707564 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11200 | $1301.00 | 1962681130 - BAYLOR SURGICARE AT PLANO, LLC, BAYLOR SCOTT & WHITE SURGICARE - PLANO | 260308454 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11200 | $506.00 | 1245605633 - HARBOR HEIGHTS SURGERY CENTER, LLC | 473886948 - (MD) HARBOR HEIGHTS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11200 | $154.61 | 1518561687 - KARI CLARIDGE | 350593390 - DEACONESS HOSPITAL INC | IN | Medical Physician Assistant (363AM0700X) |
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 11200 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11200 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 11200 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 | 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 | Low | Debridement; Subcutaneous Tissue (Includes Epidermis And Dermis If Performed); First Each 20 Sq Cm Or Less |
| 11043 | Moderate | Debridement; Muscle An/Or Fascia (Includes Epidermis Dermis And Subcutaneous Tissue Muscle And/Or Fascia If Perfomred); First 20 Sq Cm Or Less |
| 11200 | Low | *Excision (Including Simple Closure Or Ligature Strangulation), Skin Tags, Any Area; Up To 15 Lesions |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11200 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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