CPT 11623 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 11623 by major payers:
$341.84
$372.86
$382.07
$482.67
| 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 11623 | ||||||
United | 11623 | $625.00 | 1720080823 - BAPTIST-EMSC LP, EAST MEMPHIS SURGERY CENTER | 621846584 - (TN) BAPTISTEMSC LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $1955.00 | 1154844553 - LONE STAR ENDOSCOPY CENTER, LLC, LONE STAR ENDOSCOPY SOUTHLAKE | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $491.00 | 1356729636 - R CHOICE SURGICAL CENTER LLC | 473918510 - (NE) R CHOICE SURGICAL CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $445.00 | 1497843825 - COMMONWEALTH ORTHOPAEDICS & REHABILITATION, PC | 540885859 - (VA) ORTHOVIRGINIA, INC. | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $513.00 | 1568423945 - NW AMBULATORY SURGERY CENTER LLP, NW SURGERY CENTER | 383693604 - (TX) NW AMBULATORY SURGERY CENTER LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $445.00 | 1194291401 - AFFILIATED PHYSICIANS & SURGEONS, LTD | 860495569 - (AZ) AFFILIATED PHYSICIANS SURGEONS LTD | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $935.00 | 1699711556 - ESCNC LLC, EYE SURGERY CENTER OF NORTHERN CALIFORNIA | 462800751 - (CA) ESCNC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $491.00 | 1275708919 - WOMEN'S SURGICAL CENTER AT NORTHCARE, LLC | 261411936 - (CO) WOMEN S SURGICAL CENTER AT NOR | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $734.00 | 1649252883 - FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC, NACOGDOCHES SURGERY CENTER | 731589339 - (TX) FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $636.00 | 1215990247 - SOUTHERN HILLS SURGERY CENTER LP, SOUTHERN HILLS SURGERY CENTER | 200533890 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $475.00 | 1790174274 - PARKSIDE SURGERY CENTER, LLC | 472815348 - (TX) PARKSIDE SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $520.00 | 1477905271 - KATY ASC, LP, ADVANCED CARDIOVASCULAR & SURGERY CENTER AT METHODIST WEST HOUSTON | 813141435 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $759.00 | 1134663677 - CASTLE HILLS SURGICARE, LLC | 813020487 - (TX) CASTLE HILLS SURGICARE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $277.00 | 1316484447 - CAPITAL CHILDREN'S HEALTHCARE | 812837189 - (MD) CAPITAL CHILDRENS HEALTHCARE | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11623 | $735.00 | 1437138500 - CONCORD EYE SURGERY LLC | 20522032 - (NH) CONCORD EYE SURGERY LLC | NH | 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 11623 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11623 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 11623 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 |
|---|---|---|
| 11622 | Moderate | Excision Malignant Lesion Including Margins Scalp Neck Hands Feet Genitalia; Excised Diameter 1.1 Cm To 2.0 Cm (Desc Rev 1/1/03) |
| 11623 | Moderate | Excision Malignant Lesion Including Margins Scalp Neck Hands Feet Genitalia; Excised Diameter 2.1 Cm To 3.0 Cm (Desc Rev 1/1/03) |
| 11624 | Moderate | Excision Malignant Lesion Including Margins Scalp Neck Hands Feet Genitalia; Excised Diameter 3.1 Cm To 4.0 Cm (Desc Rev 1/1/03) |
| 11626 | Moderate | Excision Malignant Lesion Including Margins Scalp Neck Hands Feet Genitalia; Excised Diameter Over 4.0 Cm (Desc Rev 1/1/03) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11623. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11623 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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