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See a sample rate comparisonCPT 11640 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.
Exc F E E N L Mal Mrg 0 5cm, Excision Malignant Lesion Including Margins Face Ears Eyelids Nose Lips Excised Diameter 0 5 Cm Or Less
| 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 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 11640 |
| Medicaid Fee Schedule | View Medicaid rates for 11640 |
National average reimbursement for CPT 11640 by major payers:
$215.40
$249.72
$254.68
$212.47
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CPT 11640
5 of 25 sample ratesHigher to lower in this preview
Hss Asc Of Manhattan LLC, Hss Asc Of Manhattan
$2,833.00Published rateFlorida Orthopaedic Institute Surgery Center LLC
$1,158.00Published rateLee Summit Asc Kc LLC, Beacon Surgery Center
Lee Summit Asc Kc LLC
$671.00Published rateLagreca Eye Clinic PC, The Eye Clinic Surgicenter Lagreca Eye Clinic
Lagreca Eye Clinic, PC
$400.00Published rateMidsouth Interventional Pain Institute, LLC
Midsouth Interventional Pain Institute LLC
$189.00Published rate
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See a sample payer proposalCPT 11640 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11640 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 11640 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 |
|---|---|---|
| 11441-CPT | Low | Exc Face Mm B9 Marg 0 6 1 Cm, Excision Other Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Face Ears Eyelids Nose Lips Mucous Membrane Excised Diameter 0 6 To 1 0 Cm |
| 11640-CPT | Moderate | Exc F E E N L Mal Mrg 0 5cm, Excision Malignant Lesion Including Margins Face Ears Eyelids Nose Lips Excised Diameter 0 5 Cm Or Less |
| 11641-CPT | Moderate | Exc F E E N L Mal Mrg 0 6 1, Excision Malignant Lesion Including Margins Face Ears Eyelids Nose Lips Excised Diameter 0 6 To 1 0 Cm |
| 11642-CPT | Moderate | Exc F E E N L Mal Mrg 1 1 2, Excision Malignant Lesion Including Margins Face Ears Eyelids Nose Lips Excised Diameter 1 1 To 2 0 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11640. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11640 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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