CPT 11306 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 • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 11306 by major payers:
$128.75
$143.86
$148.88
$193.76
| 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 11306 | ||||||
United | 11306 | $645.00 | 1770149304 - BLACK RIVER AMBULATORY SURGERY CENTER, LLC | 834657999 - (MO) BLACK RIVER AMBULATORY SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $558.00 | 1487612024 - QUAD CITY AMBULATORY SURGERY CENTER LLC | 364471903 - (IL) QUAD CITY AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $275.00 | 1275132094 - COASTAL CARDIOVASCULAR CENTER, LLC, COASTAL CARDIOVASCULAR CENTER | 845144651 - (TX) COASTAL CARDIOVASCULAR CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $153.00 | 1528012978 - NORTHERN CALIFORNIA SURGERY CENTER LP | 680561196 - (CA) NORTHERN CALIFORNIA SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $566.00 | 1053714758 - TEXAS PRECISION SURGERY CENTER | 471332895 - (TX) TEXAS PRECISION SURGERY CENTER L | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $578.00 | 1992752224 - SPRINGFIELD CLINIC LLP, SPRINGFIELD CLINIC AMBULATORY SURGERY CENTER | 370701328 - (IL) SPRINGFIELD CLINIC, LLP | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $111.00 | 1225387640 - PCET SURGERY CENTER LLC | 454288531 - (TN) PCET SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $115.00 | 1407812860 - THE SURGICAL CENTER OF THE TREASURE COAST, LLC | 371446353 - (FL) SURGICAL CENTER OF THE TREASURE COAST | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $665.00 | 1245605633 - HARBOR HEIGHTS SURGERY CENTER, LLC | 473886948 - (MD) HARBOR HEIGHTS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $150.00 | 1265465025 - GEORGIA SURGICAL CENTERS INC | 43650858 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $140.00 | 1063935286 - CHESNUT INSTITUTE OF COSMETIC & RECONSTRUCTIVE SURGERY | 821592877 - (WA) CLINIC 5C | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $161.00 | 1316191430 - LAREDO DIGESTIVE HEALTH CENTER LLC | 261286495 - (TX) LAREDO DIGESTIVE HEALTH CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $1108.00 | 1851367486 - GRHS, LLC, ROCHESTER AMBULATORY SURGERY CENTER | 453685937 - (NY) ROCHESTER AMBULATORY SURGERY CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $366.00 | 1922076959 - BAPTIST HEALTH SURGERY CENTER LLC, BAPTIST HEALTH SURGERY CENTER AT KENDALL | 650663357 - (FL) BAPTIST HEALTH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11306 | $180.00 | 1265816003 - CLEARVIEW SURGERY CENTER, LLC | 474123527 - (ID) CLEARVIEW SURGERY CENTER LLC | ID | 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 11306 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11306 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 11306 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 |
| 11305 | Low | Shaving Of Epidermal Or Dermal Lesion, Single Lesion, Scalp, Neck, Hands, Feet, Genitalia; Lesion Diameter 0.5 Cm Or Less |
| 11306 | Low | Shaving Of Epidermal Or Dermal Lesion, Single Lesion, Scalp,Neck, Hands, Feet, Genitalia; Lesion Diameter 0.6 To 1.0 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11306. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11306 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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