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CPT 11765 Fee Schedule

Last Verified: November 2025

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.

Wedge Exc Skin Nail Fold (Ingrown)
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Integumentary System

Common Place of Service

11 - Office

20 - Urgent Care Facility

Common Modifiers

None

TA - Left foot, great toe

T5 - Right foot, great toe

Complexity LevelModerate

National average reimbursement for CPT 11765 by major payers:

bcbs

$183.08

uhc

$195.88

aetna

$202.86

cigna

$265.67

Preview provider-level rates for...
For billing codeCPT 11765
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 11765

United
11765$56.001588777130 - J J YOUNG MD, THE CATARACT CENTER OF LAWTON731221077 - (OK) J J YOUNG MDOKAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$605.001841255775 - DUBUQUE ENDOSCOPY CENTER LC201597161 - (IA) DUBUQUE ENDOSCOPY CENTER LCIAAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$113.001528622321 - PREMIER-COVENANT ASTC LLC, PREMIER AMBULATORY SURGERY CENTER834550993 - (TN) PREMIERCOVENANT ASTC LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$243.001073579256 - OUTPATIENT SURGICAL CARE LTD860525610 - (AZ) OUTPATIENT SURGICAL CARE LTDAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$574.001326142878 - LEBANON ENDOSCOPY CENTER LLC, LEBANON ENDOSCOPY CENTER205449574 - (TN) LEBANON ENDOSCOPY CENTER LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$136.001679544290 - KEYSTONE SURGERY CENTER, LTD43712391 - (PA) KEYSTONE SURGERY CENTER LTDPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$574.001356307565 - AMBULATORY SURGICAL ASSOCIATES LLC, TULLAHOMA SURGERY CENTER61658016 - (TN) AMBULATORY SURGICAL ASSOCIATES LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$1150.001083228365 - REFOCUS SURGERY CENTERS, LLC851258648CTAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$182.001376518357 - ORLANDO FL ENDOSCOPY ASC LLC, CITRUS AMBULATORY SURGERY CENTER202873015 - ORLANDO FL ENDOSCOPY ASC LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$127.001619643608 - CARDIOVASCULAR ASC LLC462883732 - (FL) CARDIOVASCULAR ASC LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$252.001417060898 - ENDOSCOPY CENTER OF COLORADO SPRINGS, LLC352656413COAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$103.001083144653 - GREATER PITTSBURGH SURGERY LLC821512721 - (PA) GREATER PITTSBURGH SURGERY LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$100.001376092205 - ADVANCED INTERVENTIONAL PAIN SURGERY CENTER LLC812830135 - (AR) ADVANCED INTERVENTIONAL PAIN SURGERY CENTER LLCARAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$420.001467472688 - WEST CLINIC ASTC, WEST CLINIC, PC621526296 - THE WEST CLINIC, PLLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
11765$266.001962772871 - SURGERY CENTER OF NORTHEAST TEXAS LLC, SURGERY CENTER OF NORTHEAST TEXAS454184639 - (TX) SCNETX, LLCDBA SURGERY CENTERTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 11765 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 11765 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 11765 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.

CodeComplexityDescription
11719LowTrimming Of Nondysrophic Nails, Any Number
11760ModerateReconstruction Toe Or Finger Nail Bed,Simple
11765LowWedge Exc Skin Nail Fold (Ingrown)
11770ModerateExc Pilonidal Cyst/Sinus Simple

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11765. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 11765 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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