CPT 11201 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 11201 by major payers:
$22.83
$24.42
$24.22
$30.85
| 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 11201 | ||||||
United | 11201 | $300.00 | 1598144909 - TRINITY AMBULATORY SURGICAL CENTER LLC, HEART & RHYTHM INSTITUTE OF TRINITY | 472090172 - (FL) TRINITY AMBULATORY SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $85.00 | 1770645905 - SILVER SPRING MD ENDOSCOPY ASC LLC, ENDOSCOPIC SURGICAL CENTRE OF MARYLAND | 205988845 - (MD) SILVER SPRING MD ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $92.00 | 1548296296 - ENT SURGERY CENTER OF AUGUSTA, LLC | 20577882 - (GA) ENT SURGERY CENTER OF AUGUSTA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $566.00 | 1689664906 - PEDIATRIC SURGERY CENTERS, LLC | 201711553 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $113.00 | 1083780662 - PLASTIC SURGICENTRE, INC, THE PLASTIC SURGICENTRE, INC | 911473281 - (WA) THE PLASTIC SURGICENTRE, INC. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $105.00 | 1063495257 - DOCTORS SURGICAL PARTNERSHIP LLC, MELBOURNE SAME DAY SURGERY | 593490279 - (FL) DOCTORS SURGICAL PARTNERSHIP LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $138.00 | 1801849427 - MAIN STREET ASC LLC, OPHTHALMIC ASSOCIATES SURGERY AND LASER CENTER | 383711415 - (PA) MAIN STREET ASC LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $200.00 | 1770537698 - PHYSICIANS SURGERY CENTER OF FLORENCE LLC, PHYSICIANS SURGERY CENTER OF FLORENCE | 431983435 - (SC) QHG OF SOUTH CAROLINA INC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $200.00 | 1679816342 - OAK LAWN IL ENDOSCOPY ASC LLC | 462381028 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $609.00 | 1699738112 - NORTH AUSTIN SURGERY CENTER, L.P. | 200648730 - (TX) NORTH AUSTIN SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $586.00 | 1043236664 - ST. MARY'S AMBULATORY SURGERY CENTER, LLC | 593812095 - (VA) ST MARYS AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $82.00 | 1871811257 - HILLSIDE ENDOSCOPY CENTER, LLC | 263741464 - (PA) HILLSIDE ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $79.00 | 1902213432 - COBBLESTONE SURGERY CENTER, INC. | 464241477 - (GA) COBBLESTONE SURGERY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $135.00 | 1184798837 - SHADELANDS ADVANCED ENDOSCOPY INSTITUTE, INC. | 205834466 - (CA) SHADELANDS ADVANCED ENDOSCOPY INSTITUTE INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11201 | $179.00 | 1194291401 - AFFILIATED PHYSICIANS & SURGEONS, LTD | 860495569 - (AZ) AFFILIATED PHYSICIANS SURGEONS LTD | AZ | 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 11201 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11201 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 11201 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 |
| 11201 | Low | Removal Of Skin Tags Multiple Fibrocutaneous Tags Any Area; Each Additional 10 Lesions Or Part Thereof (List In 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 11201. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11201 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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