CPT 11402 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 11402 by major payers:
$186.84
$210.12
$221.56
$277.55
| 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 11402 | ||||||
United | 11402 | $156.07 | 1487850871 - NOUSHIN HEIDARY | 232731751 - (PA) BRYN MAWR SKIN & CANCER INSTITUTE, LLC | PA | Dermatology Physician (207N00000X) |
United | 11402 | $191.33 | 1134546021 - KATHERINE FONTICHIARO | 462747350 - (MI) ADULT & PEDIATRIC DERMATOLOGY | MI | Dermatology Physician (207N00000X) |
United | 11402 | $129.47 | 1730180449 - JOHN CAZALE | 273652036 - (LA) R.WILLIAM JUNIUS, III, M.D., L.L. C. DBA CRESCENT CITY ORTHOPEDICS | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 11402 | $140.07 | 1124280953 - HEATHER HENSLEY | 832097144 - (AZ) SKIN CARE SPECIALIST PLLC | AZ | Dermatology Physician (207N00000X) |
United | 11402 | $367.22 | 1215923248 - EDWARD MORGAN | 364774713 - LSU HEALTH SCIENCES CENTER - SHREVEPORT FACULTY GROUP PRACTICE | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 11402 | $281.00 | 1154318376 - LAHAYE CENTER FOR ADVANCED EYE CARE OF LAFAYETTE, INC. | 721227426 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11402 | $557.00 | 1639377294 - BUNKIE GENERAL HOSPITAL | 720697593 | LA | Critical Access Hospital (282NC0060X) |
United | 11402 | $136.88 | 1376962860 - ASHLEY BROWN | 611085679 - (KY) ASSOCIATES IN DERMATOLOGY PLLC | KY | Dermatology Physician (207N00000X) |
United | 11402 | $189.50 | 1154366870 - VICTORIA SERRALTA | 262377948 - (TX) DERMATOLOGY CUTANEOUS SURGERY PLLC | TX | Dermatology Physician (207N00000X) |
United | 11402 | $373.14 | 1609847821 - DUANE WHITAKER | 942958258 - BANNER-UNIVERSITY MEDICAL GROUP | WA | MOHS-Micrographic Surgery Physician (207ND0101X) |
United | 11402 | $148.16 | 1952757007 - STACY BLUM | 431246913 - (MO) LAWRENCE E. SAMUELS, M.D. INC. | MO | Dermatology Physician (207N00000X) |
United | 11402 | $283.00 | 1598804486 - SHREVEPORT SURGERY CENTER PTRSHP | 721126552 - (LA) SHREVEPORT SURGERY CENTER OF CADDO PARISH, INC. | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11402 | $650.00 | 1902469653 - CLHG-DEQUINCY, LLC | 364911029 - (LA) CLHGDEQUINCY LLC | LA | Critical Access Hospital (282NC0060X) |
United | 11402 | $2664.00 | 1447597240 - BAYLOR UNIVERSITY MEDICAL CENTER | 751837454 - (TX) BAYLOR UNIVERSITY MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 11402 | $2067.00 | 1811942238 - KPH-CONSOLIDATION, INC., HCA HOUSTON HEALTHCARE NORTH CYPRESS A CAMPUS OF HCA HOUSTON HEALTHCAR | 621619857 | TX | General Acute Care Hospital (282N00000X) |
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 11402 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11402 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 11402 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 |
| 11400 | Low | Excision Benign Lesion Including Margins Except Skin Tag (Unless Listed Elsewhere) Trunk Arms Or Legs; Excised Diameter 0.5 Cm Or Less (Desc Rev 1/1/03) |
| 11402 | Low | Excision Benign Lesion Including Margins Except Skin Tag (Unless Listed Elsewhere) Trunk Arms Or Legs; Excised Diameter 1.1 Cm To 2.0 Cm (Desc Rev 1/1/03) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11402. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11402 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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