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See a sample rate comparisonHealthcare 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 |
| Medicare Fee Schedule | View Medicare rates for 11646 |
| Medicaid Fee Schedule | View Medicaid rates for 11646 |
National average reimbursement for CPT 11646 by major payers:

$594.19

$649.12

$657.18

$636.07
Choose a payer to see a sample of rates for CPT 11646.
Wisconsin Surgery Center, LLC
Tlc Asc LLC
Torrance Endoscopy And Surgical Affiliates Inc
Toledo Endoscopy Asc LLC
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 11646 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11646 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 11646 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 |
|---|---|---|
| 11446-CPT | Moderate | Exc Face Mm B9 Marg 4 Cm, Excision Other Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Face Ears Eyelids Nose Lips Mucous Membrane Excised Diameter Over 4 0 Cm |
| 11643-CPT | Moderate | Exc F E E N L Mal Mrg 2 1 3, Excision Malignant Lesion Including Margins Face Ears Eyelids Nose Lips Excised Diameter 2 1 To 3 0 Cm |
| 11644-CPT | Moderate | Exc F E E N L Mal Mrg 3 1 4, Excision Malignant Lesion Including Margins Face Ears Eyelids Nose Lips Excised Diameter 3 1 To 4 0 Cm |
| 11646-CPT | Moderate | Exc F E E N L Mal Mrg 4 Cm, Excision Malignant Lesion Including Margins Face Ears Eyelids Nose Lips Excised Diameter Over 4 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 11646. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11646 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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