CPT 11443 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 11443 by major payers:
$263.54
$284.94
$297.37
$371.30
| 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 11443 | ||||||
United | 11443 | $520.00 | 1427020213 - TOLEDO ENDOSCOPY ASC LLC, NORTHWEST OHIO ENDOSCOPY CENTER | 621734002 - (OH) TOLEDO ENDOSCOPY ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $1713.00 | 1477590545 - SOUTHERN HILLS MEDICAL CENTER, LLC, SOUTHERN HILLS HOSPITAL & MEDICAL CENTER | 743048428 - (NV) SOUTHERN HILLS MEDICAL CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $1088.00 | 1235146325 - WEBSTER AMBULATORY SURGERY CENTER LP, WEBSTER SURGERY CENTER | 205953387 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $2718.00 | 1053391870 - NORTHWEST SURGERY CENTER, LTD, NORTHWEST SURGERY CENTER RED OAK | 760452319 - (TX) NORTHWEST SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $265.00 | 1700205150 - OHI WEST, INC, BAYFRONT HEALTH AMBULATORY SURGERY CENTER | 845074208 - (FL) OHI WEST INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $401.00 | 1598879512 - NORTHLAND EYE SURGERY CENTER, LLC | 203685944 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $967.00 | 1639134505 - PUEBLO AMBULATORY SURGERY CENTER LLC | 621488737 - (CO) PUEBLO AMBULATORY SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $1927.00 | 1407981327 - ARIA HEALTH TORRESDALE -SPU | 230596940 - (PA) JEFFERSON HEALTH-NORTHEAST | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $646.00 | 1346270329 - MARY IMMACULATE AMBULATORY SURGERY CENTER LLC | 200485202 - (VA) MARY IMMACULATE AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $428.00 | 1215204128 - MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, P.C., ALLSPINE SURGERY CENTER, P.C. | 274395849 - (GA) MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $542.00 | 1114696234 - ONE NINETEEN GI ASC, LLC | 862162590 - (AL) ONE NINETEEN GI ASC LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $706.00 | 1669895512 - AMBULATORY SURGICAL CENTER OF SOMERVILLE LLC, SOMERSET AMBULATORY SURGICAL CENTER | 371743209 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $2266.00 | 1396774543 - WISCONSIN SURGERY CENTER LLC | 383661215 - (WI) WISCONSIN SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $641.00 | 1356572465 - ORCHARD CREEK SURGERY CENTER, ORCHARD CREEK SURGERY CENTER | 770498874 - (CA) ORCHARD CREEK SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11443 | $399.00 | 1063164960 - ADVANCED SURGICAL CARE OF VIERA, LLC | 872178964 - (FL) ADVANCED SURGICAL CARE OF VIERA 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 11443 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11443 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 11443 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 |
|---|---|---|
| 11442 | Moderate | Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Face, Ears, Eyelids, Nose, Lips, Mucous Membrane; Excised Diameter 1.1 To 2.0 Cm |
| 11443 | Moderate | Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Face, Ears, Eyelids, Nose, Lips, Mucous Membrane; Excised Diameter 2.1 To 3.0 Cm |
| 11444 | Moderate | Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Face, Ears, Eyelids, Nose, Lips, Mucous Membrane; Excised Diameter 3.1 To 4.0 Cm |
| 11642 | Moderate | Excision Malignant Lesion Including Margins Face Ears Eyelids Nose Lips; 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 11443. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11443 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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