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See a sample rate comparisonCPT 11404 Fee Schedule
Last Verified: October 2026
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.
Exc Tr Ext B9 Marg 3 1 4 Cm, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Trunk Arms Or Legs Excised Diameter 3 1 To 4 0 Cm
| 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 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 11404 |
| Medicaid Fee Schedule | View Medicaid rates for 11404 |
National average reimbursement for CPT 11404 by major payers:
$244.97
$275.63
$289.28
$268.79
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CPT 11404
5 of 25 sample ratesHigher to lower in this preview
Surgery Affiliate Of El Paso, LLC, Foundation Surgery Affiliate Of El Paso, LLC
Surgery Affiliate Of El Paso LLC
$3,776.00Published rateOrthoarizona Surgery Center Gilbert, LLC, Orthoarizona Surgery Center Gilbert
Orthoarizona Surgery Center Gilbert LLC
$1,528.00Published rateThe Surgery Center, LLC
The Surgery Center LLC
$970.00Published rateEye Associates Surgery Center Inc, Cascadia Surgical
Eye Associates Surgery Center Inc
$589.00Published rateAndersen Eye Surgery Center, LLC
Andersen Eye Surgery Center LLC
$370.00Published rate
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See a sample payer proposalCPT 11404 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11404 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 11404 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 |
|---|---|---|
| 11400-CPT | Low | Exc Tr Ext B9 Marg 0 5 Cm, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Trunk Arms Or Legs Excised Diameter 0 5 Cm Or Less |
| 11401-CPT | Low | Exc Tr Ext B9 Marg 0 6 1 Cm, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Trunk Arms Or Legs Excised Diameter 0 6 To 1 0 Cm |
| 11402-CPT | Low | Exc Tr Ext B9 Marg 1 1 2 Cm, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Trunk Arms Or Legs Excised Diameter 1 1 To 2 0 Cm |
| 11404-CPT | Moderate | Exc Tr Ext B9 Marg 3 1 4 Cm, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Trunk Arms Or Legs Excised Diameter 3 1 To 4 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 11404. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11404 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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