CPT 11303 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 • 99 - Other POS |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 11303 by major payers:
$155.85
$184.77
$187.10
$244.17
| 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 11303 | ||||||
United | 11303 | $331.00 | 1750312435 - CENTRAL ARIZONA ENDOSCOPY LLC | 203643513 - (AZ) CENTRAL ARIZONA ENDOSCOPY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $588.00 | 1689755894 - SKIN SURGERY CENTER PS, SKIN SURGERY CENTER | 911954101 - (WA) SKIN SURGERY CENTER P. S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $90.00 | 1265438303 - EYE SURGERY CENTER OF CHATTANOOGA, LLC | 200149350 - (TN) EYE SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $125.00 | 1881962348 - CENTER FOR SPINE AND PAIN MEDICINE PC, CSPM CHATTANOOGA ASC | 341976829 - CENTER FOR SPINE AND PAIN MEDICI | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $250.00 | 1790862183 - CATARACT AND LASER CENTER OF THE NORTH SHORE, LLC | 43388939 - (MA) CATARACT AND LASER CENTER OF THE NORTH SHORE LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $560.00 | 1114264488 - EXECUTIVE SURGERY CENTER, LLC | 300701899 - (TX) EXECUTIVE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $121.00 | 1972232981 - SOUTHPOINT SURGERY CENTER LLC | 841989776 - (NC) SOUTHPOINT SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $612.00 | 1659953636 - VCU HEALTH AMBULATORY SURGERY CENTER, LLC | 863310585 - (VA) VCU HEALTH AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $95.00 | 1770572307 - BETHESDA SURGERY CENTER, LLC | 522080005 - (MD) BETHESDA SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $506.00 | 1467796730 - WINDSOR MILL SURGERY CENTER, LLC | 461412275 - (MD) WINDSOR MILL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $125.00 | 1205171295 - VANCE THOMPSON VISION SURGERY CENTER PROF LLC, VANCE THOMPSON VISION SURGERY CENTER | 843362063 | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $89.00 | 1265907885 - APEX SURGERY CENTER, LLC | 814252902 - (OK) APEX SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $44.00 | 1346270428 - BALTIMORE AMBULATORY CENTER FOR ENDOSCOPY | 521913193 - (MD) BALTIMORE AMBULATORY CENTER FO | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $42.00 | 1609026533 - EYE SURGICENTER LLC | 651005108 - (FL) EYE SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11303 | $400.00 | 1952912552 - SURGERY CENTER OF NORTH CENTRAL OHIO LLC, THE SURGERY CENTER OF NORTH CENTRAL OHIO | 833986181 - (OH) THE SURGERY CENTER OF NORTH CENT | OH | 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 11303 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11303 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 11303 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 |
|---|---|---|
| 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 |
| 11300 | Low | Shave Dermal Lgs Trunk Ext To 0.5cm |
| 11303 | Low | Shave Dermal Les Trunk Ext Over 2.0 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11303. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11303 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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