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CPT 11451 Fee Schedule

Last Verified: January 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 Hidradenitis Axilla W Oth Clos
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Integumentary System

Common Place of Service

22 - On Campus Outpatient Hospital

24 - Ambulatory Surgical Center

Common Modifiers

None

RT - Right side of body

LT - Left side of body

Complexity LevelModerate

National average reimbursement for CPT 11451 by major payers:

bcbs

$609.26

uhc

$621.18

aetna

$655.94

cigna

$819.62

Preview provider-level rates for...
For billing codeCPT 11451
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 11451

United
11451$2119.001295776920 - ROSE AMBULATORY SURGERY CENTER LP200415436 - (CO) ROSE AMBULATORY SURGERY CENTER LPCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$2353.001124261771 - KHS AMBULATORY SURGERY CENTER, LLC, SELECT SURGICAL CENTER AT KENNEDY260715364 - (NJ) KHS AMBULATORY SURGERY CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$795.001306924170 - DELMAR SURGICAL CENTER LLC621717312 - (MD) DELMAR SURGICAL CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$900.001942548870 - ISPM ASC AT CAMP CREEK LLC, ALLIANCE SURGERY CENTER AT CAMP CREEK461000991 - (GA) ISPM ASC AT CAMP CREEK LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$1837.001033154851 - PARKWEST SURGERY CENTER LP621808841 - (TN) PARKWEST SURGERY CENTER LPTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$1100.001164930731 - REMBRANDT OUTPATIENT SURGERY CENTER PLLC, REMBRANDT OUTPATIENT SURGERY CENTER822368976 - (AZ) REMBRANDT OUTPATIENT SURGERY CENTER PLLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$2000.001780218305 - THE UNIVERSITY OF TEXAS AT AUSTIN, UT HEALTH AUSTIN AMBULATORY SURGERY CENTER746000203TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$1148.001023071180 - SAHARA OUTPATIENT SURGERY CENTER LTD752509486 - (NV) SAHARA OUTPATIENT SURGERY CENTER LTDNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$811.001205963568 - BRYN MAWR MEDICAL SPECIALISTS ASSOCIATION231714249 - (PA) BRYN MAWR MEDICAL SPECIALISTS ASSOCIATIONPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$2594.001962505354 - PROVIDENCE HEALTH SERVICES OF WACO, PROVIDENCE HEALTH CENTER741109636 - (TX) ASCENSION PROVIDENCETXAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$2346.001245657840 - SURGCENTER OF PLANO LLC462873916 - (TX) SURGCENTER OF PLANO, LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$1200.001831801117 - SIGHT PARTNERS, LLC, EMPIRE EYE PHYSICIANS833467355WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$777.001922104710 - OAKS SURGERY CENTER LP753019861 - (CA) OAKS SURGERY CENTER LP THE OAKCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$1291.001801899687 - TRINITY SURGERY CENTER LLC, BAYCARE SURGERY CENTER20656933 - (FL) TRINITY SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
11451$412.001598093007 - TARBORO ENDOSCOPY CENTER, LLC271345858 - (NC) TARBORO ENDOSCOPY CENTER LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 11451 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 11451 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 11451 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.

CodeComplexityDescription
11450-CPTModerateExc Tiss Axillary Simple/Intermed
11451-CPTModerateExc Hidradenitis Axilla W Oth Clos
11462-CPTModerateExc Tiss Inguinal Simple/Intermed
11463-CPTModerateExc Hidradenitis Inguin W Oth Clos

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11451. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 11451 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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