CPT 11646 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 11646 by major payers:
$594.19
$649.12
$657.18
$821.87
| 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 11646 | ||||||
United | 11646 | $750.00 | 1700854072 - SULLIVAN SURGICENTER,LLC | 352124714 - (IN) SULLIVAN SURGICENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $935.00 | 1013468586 - LAKEWAY AMBULATORY SURGERY CENTER, LLC, LAKEWAY SURGERY CENTER | 383992761 - (TX) LAKEWAY AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $1418.00 | 1891728382 - MISSISSIPPI COAST ENDOSCOPY & AMBULATORY CENTER LLC, MISSISSIPPI COAST ENDOSCOPY & AMBULATORY SURGICAL | 640927074 - (MS) MISSISSIPPI COAST ENDOSCOPY AND AMBULATORY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $900.00 | 1578508875 - CLERMONT AMBULATORY SURGICAL CENTER | 202139893 - (FL) CLERMONT AMBULATORY SURGICAL CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $935.00 | 1992752794 - SIERRA EYE AMBULATORY SURGERY CENTER, LLC | 770509889 - (CA) SIERRA EYE AMBULATORY SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $935.00 | 1700838471 - SANTA CRUZ SURGERY CENTER | 770194916 - (CA) SANTA CRUZ SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $1816.00 | 1497165179 - SURGERY CENTER OF SCOTTSDALE, LLC, MOUNTAIN VIEW SURGERY CENTER OF PHOENIX | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $897.00 | 1689679680 - TOSC, LLC, OSC-HMHP, LLC | 10724836 - (OH) THE ORTHOPAEDIC SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $986.00 | 1891754271 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, DIGESTIVE HEALTH NETWORK ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $1800.00 | 1649350844 - NORTHERN PLAINS SURGERY CENTER LLC | 450447247 - (ND) NORTHERN PLAINS SURGERY CENTER, LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $2740.00 | 1205364981 - MERCED AMBULATORY SURGERY CENTER, LLC, UNIVERSITY SURGERY CENTER | 611845381 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $1575.00 | 1215993100 - GAINESVILLE SURG CTR LP | 621600268 - (GA) GAINESVILLE SURG CTR LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $1116.00 | 1871538694 - SOUTHWEST ENDOSCOPY LTD | 850452091 - (NM) SOUTHWEST ENDOSCOPY LTD | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $2388.00 | 1366684326 - PRINCE FREDERICK SURGERY CENTER LLC | 264387021 - (MD) PRINCE FREDERICK SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11646 | $935.00 | 1477527398 - TEMECULA CA ENDOSCOPY ASC LP, TEMECULA VALLEY ENDOSCOPY CENTER | 200095307 - (CA) TEMECULA CA ENDOSCOPY ASC LP | CA | 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 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 | Moderate | 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 |
| 11641 | Moderate | Excision Malignant Lesion Including Margins Face Ears Eyelids Nose Lips; Excised Diameter 0.6 Cm To 1.0 Cm (Desc Rev 1/1/03) |
| 11642 | 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) |
| 11646 | Moderate | Ex Mal Les Face/Adnexa Over 4cm |
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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