CPT 11470 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 11470 by major payers:
$478.04
$525.92
$562.55
$705.06
| 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 11470 | ||||||
United | 11470 | $1138.00 | 1467429233 - WILLOW SPRINGS SURGERY CENTER, LTD, FOREST MED-SURG CENTER | 364391641 - (IL) WILLOW SPRINGS SURGERY CENTER LTD | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $756.00 | 1841589116 - RENAISSANCE SURGERY CENTER OF CHATTANOOGA, LLC | 273013392 - (TN) RENAISSANCE SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $1847.00 | 1730401571 - CHILDRENS SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER MAITLAND | 262389638 - (FL) CHILDRENS SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $1350.00 | 1346244845 - LAKELAND SURGICAL & DIAGNOSTIC CENTER LLP | 934728316 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $1150.00 | 1730789231 - ZEO SURGICAL CENTER LLC, LENZA SURGICAL CENTER | 853310734 - (TX) ZEO SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $1678.00 | 1124093588 - UROLOGY SURGERY CENTER OF SAVANNAH, LLLP, UROLOGY SURGERY CENTER, LLP | 582511751 - (GA) UROLOGY SURGERY CENTER OF SAVANNAH LLLP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $1850.00 | 1346205481 - BLOOMINGTON EYE INSTITUTE LLC | 371361486 - (IL) BLOOMINGTON EYE INSTITUTE LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $1658.00 | 1154996361 - CHADDS FORD AMBULATORY SURGICAL CENTER, LLC | 831876495 - (PA) CHADDS FORD AMBULATORY SURGICAL CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $1000.00 | 1154442630 - GASTROENTEROLOGY ASSOCIATES PA, GASTROENTEROLOGY ASSOCIATES ENDOSCOPY UNIT | 561972669 - (NC) GASTROENTEROLOGY ASSOCIATES, PA | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $7081.00 | 1174969372 - AURORA GI ASC LLC, WISCONSIN DIGESTIVE HEALTH CENTER | 461848055 - (WI) AURORA GI ASC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $1762.00 | 1720011042 - PREMIER ORTHOPAEDIC SURGERY CENTER, LLC | 352433859 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $1000.00 | 1831349406 - GASTROENTEROLOGY EAST, P.A. | 202964888 - (NC) GASTROENTEROLOGY EAST, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $1228.00 | 1346581105 - MD LASER SURGERY CENTER, LLC | 462169227 - (MD) MD LASER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $3500.00 | 1609870336 - DESOTO SURGICARE PARTNERS, LTD, NORTH TEXAS SURGERY CENTER | 752592508 - (TX) DESOTO SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11470 | $850.00 | 1558328518 - BUTLER AMBULATORY SURGERY CENTER L L C | 61728190 - (PA) BUTLER AMBULATORY SURGERY CENTER, LLC | PA | 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 11470 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11470 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 11470 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 |
|---|---|---|
| 11470-CPT | Moderate | Excision Of Skin And Subcutaneous Tissue For Hidradenitis, Perianal, Perineal, Or Umbilical; With Simple Or Intermediate Repair |
| 11471-CPT | Moderate | Excision Of Skin And Subcutaneous Tissue For Hidradenitis, Perianal, Perineal, Or Umbilical; With Other Closure |
| 11600-CPT | Moderate | Exc Malig Les Trnk/Arm/Leg To 0.5cm |
| 11601-CPT | Moderate | Exc Mal Les Trunk Limbs 0.5-1cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11470. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11470 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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