CPT 11424 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 11424 by major payers:
$261.23
$295.33
$307.53
$384.42
| 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 11424 | ||||||
United | 11424 | $592.00 | 1063649978 - IMPERIAL CALCASIEU SURGICAL CENTER LLC, CHRISTUS IMPERIAL CALCASIEU SURGICAL CENTER | 205109610 - (LA) IMPERIAL CALCASIEU SURGICAL CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $653.00 | 1093736795 - HATTIESBURG CLINIC PA, AMBULATORY SURGERY CENTER | 640507572 - HATTIESBURG CLINIC, P.A. | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $515.00 | 1538119185 - SPECIALITY SURGERY OF OCALA LLC | 842579958 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $1233.00 | 1871594275 - DESTIN SURGERY CENTER LLC | 593723179 - (FL) DESTIN SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $755.00 | 1356954648 - ASC OF THE HEART INSTITUTE | 823433427 - (NM) ASC OF THE HEART INSTITUTE | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $3157.00 | 1699144915 - WEST ORANGE ASC LLC, GREGORI SURGERY CENTER | 474739080 - (NJ) WEST ORANGE ASC LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $437.00 | 1437232758 - SHADY GROVE REPRODUCTIVE SCIENCE CENTER PC, SGFC SURGERY CENTER | 208131466 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $790.00 | 1386652667 - MACON OUTPATIENT SURGERY, LLC | 203027560 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $1233.00 | 1952749491 - HAYMARKET SURGERY CENTER, LLC | 462874962 - (VA) HAYMARKET SURGERY CENTER | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $611.00 | 1790062636 - BAY SURGERY CENTERS, CLEARWAY SURGERY CENTER OF WALDORF | 453365193 - (MD) BAY SURGERY CENTERS | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $1509.00 | 1588656508 - SAINT THOMAS CAMPUS SURGICARE LP | 752959131 - (TN) SAINT THOMAS CAMPUS SURGICARE LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $715.00 | 1497347934 - INTEGRIS DDSI ENDOSCOPY CENTERS LLC | 854253589 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $1258.00 | 1386086411 - MARION SURGERY CENTER, LLC | 462447139 - (FL) MARION SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $1258.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11424 | $475.00 | 1760847792 - OCALA FL ORTHOPAEDIC ASC LLC | 472831130 - (FL) OCALA FL ORTHOPAEDIC ASC, LLC | FL | 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 11424 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11424 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 11424 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 |
| 11420 | Low | Excision Benign Lesion Including Margins Except Skin Tag (Unless Listed Elsewhere) Scalp Neck Hands Feet Genitalia; Excised Diameter 0.5 Cm Or Less (Desc Rev 1/1/03) |
| 11424 | Moderate | Excision Benign Lesion Including Margins Except Skin Tag (Unless Listed Elsewhere) Scalp Neck Hands Feet Genitalia; Excised Diameter 3.1 Cm To 4.0 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 11424. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11424 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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