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See a sample rate comparisonCPT 11406 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 4 0 Cm, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Trunk Arms Or Legs Excised Diameter Over 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 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 11406 |
| Medicaid Fee Schedule | View Medicaid rates for 11406 |
National average reimbursement for CPT 11406 by major payers:
$337.22
$390.36
$414.57
$390.99
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CPT 11406
5 of 25 sample ratesHigher to lower in this preview
Sjv Management, LLC, South Jersey Vascular Surgery Center
Sjv Management, LLC
$5,127.00Published rateCapital Region Ambulatory Surgery Center, L.L.C.
Capital Region Ambulatory Surgery Center LLC
$1,631.00Published rateAesthetic Associates Inc., P.S., Seattle Facial Plastic Surgery Center
Aesthetic Associates Inc Ps
$875.00Published rateEndoscopy Center Of Knoxville Lp, The Endoscopy Center West
Endoscopy Center Of Knoxville Lp
$667.00Published rateApollo Surgery Center LLC
$296.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 11406 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11406 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 11406 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 |
| 11406-CPT | Moderate | Exc Tr Ext B9 Marg 4 0 Cm, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Trunk Arms Or Legs Excised Diameter Over 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 11406. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11406 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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