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See a sample rate comparisonCPT 11463 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.
Xcision Of Skin & Subcutane Tissue For Hidradenitis Inguinal;, Excision Of Skin And Subcutaneous Tissue For Hidradenitis Inguinal; W
| Key Fact | Detail |
|---|---|
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 11463 |
| Medicaid Fee Schedule | View Medicaid rates for 11463 |
National average reimbursement for CPT 11463 by major payers:
$624.87
$631.78
$673.58
$538.88
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CPT 11463
5 of 25 sample ratesHigher to lower in this preview
Roc Surgery LLC, Riley Outpatient Surgery Center
Roc Surgery LLC
$8,705.00Published rateBethesda Chevy Chase Surgery Center, LLC
Bethesda Chevy Chase Surgery Cen
$2,206.00Published rateScent Asc Opportunity Fund LLC, Scent Surgical Center
Scent Asc Opportunity Fund LLC
$1,276.00Published rateSurgery Center Of Sandusky LLC, Surgery Center Of Sandusky
Surgery Center Of Sandusky LLC
$986.00Published rateSaint Joseph Health Asc LLC
The Pain Treatment Center, Inc. Dba Stone Road S
$496.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 11463 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11463 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 11463 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 |
|---|---|---|
| 11450-CPT | Moderate | Xcision Of Skin & Subcutane Tissue For Hidradenitis Axillary;, Excision Of Skin And Subcutaneous Tissue For Hidradenitis Axillary; W |
| 11451-CPT | Moderate | Xcision Of Skin & Subcutane Tissue For Hidradenitis Axillary;, Excision Of Skin And Subcutaneous Tissue For Hidradenitis Axillary; W |
| 11462-CPT | Moderate | Exc Skn Hdrdnt Ing Smpl Ntrm, Excision Of Skin And Subcutaneous Tissue For Hidradenitis Inguinal With Simple Or Intermediate Repair |
| 11463-CPT | Moderate | Xcision Of Skin & Subcutane Tissue For Hidradenitis Inguinal;, Excision Of Skin And Subcutaneous Tissue For Hidradenitis Inguinal; W |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11463. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11463 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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