CPT 11471 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 • 21 - Inpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 11471 by major payers:
$592.03
$650.18
$663.15
$855.75
| 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 11471 | ||||||
United | 11471 | $2850.00 | 1477519130 - SURGICARE OF MINNEAPOLIS LTD, SURGICAL SPECIALTY CENTER OF MINNESOTA | 411624905 | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $2533.00 | 1528104080 - SURGICAL CENTER AT CEDAR KNOLLS LLC | 202158771 - (NJ) SURGICAL CENTER AT CEDAR KNOLLS | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $2050.00 | 1376558965 - SPECIALTY SURGICAL CENTER OF BEVERLY HILLS LP, SPECIALTY SURGICAL CENTER | 200140317 - (CA) SPECIALTY SURGICAL CENTER OF BEVERLY HILLS, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $1339.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $1431.00 | 1023036688 - BAYSIDE AMBULATORY CENTER, LLC | 510438152 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $1530.00 | 1295906956 - THE ENT CENTER OF RHODE ISLAND LLC, THE SURGERY CENTER OF RHODE ISLAND | 260329297 - (RI) THE ENT CENTER OF RHODE ISLAND | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $494.00 | 1437237393 - LAUREL AMBULATORY SURGICAL CENTER | 263869837 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $2884.00 | 1154785848 - PROSPECT CCMC, LLC | 811507712 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $1549.00 | 1578221479 - SKIN CANCER AND LASER SURGERY CENTER LLC | 854119523 - (IN) SKIN CANCER AND LASER SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $814.00 | 1649957168 - BLUE ASH ENDOSCOPY CENTER, LLC | 931613837 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $1171.00 | 1396277208 - ELITE SURGERY CENTER, LLC | 820836081 - (CA) ELITE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $2564.00 | 1851029060 - COLORADO SPRINGS SURGICENTER, LLC | 862813124 - COLORADO SPRINGS SURGICENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $1100.00 | 1780604694 - CLEARVIEW SURGERY CENTER INC | 202828714 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $900.00 | 1124277959 - CPM SURGERY CENTER 2, LLC | 263297791 - (GA) CPM SURGERY CENTER 2 LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11471 | $1009.00 | 1023005139 - ROANOKE VALLEY CENTER FOR SIGHT LLC | 541982898 - (VA) ROANOKE VALLEY CENTER FOR SIGHT LLC | VA | 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 11471 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11471 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 11471 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 11471. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11471 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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