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CPT 11463 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 Inguin 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

LT - Left side of body

RT - Right side of body

Complexity LevelModerate

National average reimbursement for CPT 11463 by major payers:

bcbs

$624.87

uhc

$631.78

aetna

$673.58

cigna

$830.82

Preview provider-level rates for...
For billing codeCPT 11463
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 11463

United
11463$986.001295841666 - SURGERY CENTER OF SANDUSKY LLC, SURGERY CENTER OF SANDUSKY204913215 - (OH) SURGERY CENTER OF SANDUSKY LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
11463$1400.001821379538 - THE AESTHETIC SURGERY CENTRE, PLLC, CEDAR LASER AND SURGERY CENTER900210545 - (WA) AESTHETIC SURGERY CENTRE, PLLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
11463$5968.001073558912 - CHRISTUS SANTA ROSA SURGERY CENTER L.L.P., CHRISTUS SANTA ROSA SURGERY CENTER810571409TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
11463$869.651114902160 - JOSEPH WALING350593390 - DEACONESS HOSPITAL INCINInterventional Pain Medicine Physician (208VP0014X)
United
11463$496.001669075495 - SAINT JOSEPH HEALTH ASC LLC611235517 - (KY) THE PAIN TREATMENT CENTER, INC. DBA STONE ROAD SKYAmbulatory Surgical Clinic/Center (261QA1903X)
United
11463$2307.001063099190 - ASCENSION SAINT THOMAS LEBANON SURGERY CENTER LLC, LEBANON SURGERY CENTER862679471TNAmbulatory Surgical Clinic/Center (261QA1903X)
United
11463$1276.001437736071 - SCENT ASC OPPORTUNITY FUND LLC, SCENT SURGICAL CENTER862520870 - (SC) SCENT ASC OPPORTUNITY FUND LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
11463$1542.001881125870 - RENAL ASSOCIATES, P.A.742083988 - (TX) RENAL ASSOCIATES, PATXAmbulatory Surgical Clinic/Center (261QA1903X)
United
11463$1000.001346662186 - NATIONAL SURGICAL CENTERS OF AMERICA LLC, NSCOA PORT ST. LUCIE264278807 - (FL) NATIONAL SURGICAL CENTERS OF AMERICA LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
11463$2564.001851029060 - COLORADO SPRINGS SURGICENTER, LLC862813124 - COLORADO SPRINGS SURGICENTER LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
11463$1926.001720572415 - APC-AMARILLO SURGICAL OPERATING COMPANY, LLC, ADVANCED SURGICAL CENTER - AMARILLO822413483 - (TX) APCAMARILLO SURGICAL OPERATING COMPANY LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
11463$1190.001134182546 - JACKSONVILLE SURGERY CENTER, LTD621600402 - (FL) JACKSONVILLE SURGERY CENTER LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
11463$869.651376749341 - FAHHAD FARUKHI350593390 - DEACONESS HOSPITAL INCILHospitalist Physician (208M00000X)
United
11463$1700.001871581876 - OPHTHALMOLOGY LTD EYE SURGERY CENTER LLC411911652 - (SD) OPHTHALMOLOGY, LTD EYE SURGERY CENTERSDAmbulatory Surgical Clinic/Center (261QA1903X)
United
11463$1001.001922178169 - IMPERIAL HEALTH, LLP721005645 - (LA) IMPERIAL HEALTH, LLPLAAmbulatory 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 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.

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 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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