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See a sample rate comparisonCPT 11423 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 H F Nk Sp B9 Marg 2 1 3, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Scalp Neck Hands Feet Genitalia Excised Diameter 2 1 To 3 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 11423 |
| Medicaid Fee Schedule | View Medicaid rates for 11423 |
National average reimbursement for CPT 11423 by major payers:
$224.64
$255.93
$268.50
$258.42
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CPT 11423
5 of 25 sample ratesHigher to lower in this preview
The Emory Clinic Inc, Emory Ambulatory Surgery Center At Spivey Station
Emory University
$3,022.00Published rateEndoscopic Diagnostic & Treatment Center LLC
Endoscopic Diagnostic Treatment Center LLC
$1,500.00Published rateWest Palm Outpatient Surgery And Laser Center Ltd, Northpoint Surgery & Laser Center
$661.00Published rateThe Center For Aesthetic Surgery LLC
$535.00Published rateJessica Trimer
Deaconess Hospital Inc
$162.25Published rate
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See a sample payer proposalCPT 11423 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11423 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 11423 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 |
|---|---|---|
| 11420-CPT | Low | Exc H F Nk Sp B9 Marg 0 5, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Scalp Neck Hands Feet Genitalia Excised Diameter 0 5 Cm Or Less |
| 11421-CPT | Low | Exc H F Nk Sp B9 Marg 0 6 1, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Scalp Neck Hands Feet Genitalia Excised Diameter 0 6 To 1 0 Cm |
| 11422-CPT | Low | Exc H F Nk Sp B9 Marg 1 1 2, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Scalp Neck Hands Feet Genitalia Excised Diameter 1 1 To 2 0 Cm |
| 11423-CPT | Moderate | Exc H F Nk Sp B9 Marg 2 1 3, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Scalp Neck Hands Feet Genitalia Excised Diameter 2 1 To 3 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 11423. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11423 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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