CPT 11643 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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 11643 by major payers:
$332.71
$400.75
$411.24
$516.25
| 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 11643 | ||||||
United | 11643 | $317.00 | 1437871373 - NORTHEAST INDIANA AMBULATORY SURGERY CENTER LLC | 830979985 - (IN) NORTHEAST INDIANA AMBULATORY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $934.00 | 1205949245 - MEMORIAL SURGERY CENTER, LLC | 201167151 - (OK) MEMORIAL SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $1089.00 | 1891759569 - ST JOSEPH CENTER FOR OUTPATIENT SURGERY, LLC | 680510220 - (MO) ST JOSEPH CENTER FOR OUTPATIENT SURGERY LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $251.00 | 1235105248 - GURLEY SURGERY CENTER, THE GYN CENTER | 621159796 - (TN) GURLEY SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $935.00 | 1407829773 - LA JOLLA ENDOSCOPY CENTER LP, LA JOLLA ENDOSCOPY CENTER | 621806062 - (CA) LA JOLLA ENDOSCOPY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $400.00 | 1689133290 - MOHAWK SURGERY CENTER LLC | 830632231 - (FL) MOHAWK SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $432.00 | 1972568830 - FLORENCE SURGERY CENTER, L.P., FLORENCE SURGERY CENTER | 621551098 - (AL) FLORENCE SURGERY CENTER LP | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $935.00 | 1063819860 - TYLER ASC, LP, TYLER CARDIAC & ENDOVASCULAR SURGERY CENTER | 471418553 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $935.00 | 1568979805 - ST DAVIDS AUSTIN AREA ASC LLC, ST . DAVID'S AUSTIN SURGERY CENTER | 611760247 - (TX) ST DAVIDS AUSTIN AREA ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $935.00 | 1720023484 - SPALDING TRIANGLE SURGERY CENTER, LLC, SPALDING TRIANGLE SURGERY CENTER | 760769099 - (CA) SPALDING TRIANGLE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $564.00 | 1053336602 - VIRGINIA EYE INSTITUTE INC, VIRGINIA EYE INSTITUTE SURGERY PAVILION | 541420580 - (VA) VIRGINIA EYE INSTITUTE INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $240.00 | 1710952130 - MARYLAND ENDOSCOPY CENTER LLC, MARYLAND ENDOSCOPY CENTER | 521888989 - (MD) MARYLAND ENDOSCOPY CENTER, LLC. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $310.00 | 1205978780 - MOUNTAIN HOME SURGERY CENTER | 454157268 | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $1554.00 | 1619218096 - SAN MARCOS ASC LLC | 800899088 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11643 | $258.00 | 1316976137 - CENTRAL MARYLAND ENDOSCOPY LLC | 201580201 - (MD) CENTRAL MARYLAND ENDOSCOPY LLC | MD | 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 11643 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11643 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 11643 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 |
|---|---|---|
| 11444-CPT | Moderate | Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Face, Ears, Eyelids, Nose, Lips, Mucous Membrane; Excised Diameter 3.1 To 4.0 Cm |
| 11623-CPT | 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) |
| 11642-CPT | Moderate | Excision Malignant Lesion Including Margins Face Ears Eyelids Nose Lips; Excised Diameter 1.1 Cm To 2.0 Cm (Desc Rev 1/1/03) |
| 11643-CPT | Moderate | Excision Malignant Lesion Including Margins Face Ears Eyelids Nose Lips; Excised Diameter 2.1 Cm To 3.0 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 11643. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11643 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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