CPT 11772 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • SG - Scene to Hospital ESRD facility • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 11772 by major payers:
$833.53
$892.21
$968.64
$1,203.22
| 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 11772 | ||||||
United | 11772 | $614.00 | 1295131001 - OPTUMCARE COLORADO ASC, LLC, COLORADO SPRINGS HEALTH PARTNERS ASC, LLC | 352597463 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11772 | $1026.00 | 1508862160 - TRIAD SURGERY CENTER LLC, TRIAD EYE MEDICAL CLINIC AND CATARACT INSTITUTE PLLC | 473510624 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11772 | $1645.00 | 1457378333 - BEAUMONT SURGICAL AFFILIATES, LTD, BAPTIST BEAUMONT SURGICAL AFFILIATES | 821773443 - (TX) BEAUMONT SURGICAL AFFILIATES | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11772 | $1422.00 | 1255607628 - MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, PC, ALLSPINE SURGERY CENTER | 274395849 - (GA) MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11772 | $390.00 | 1639352347 - THE KISSIMMEE FL ENDOSCOPY ASC LLC, KISSIMMEE ENDOSCOPY CENTER | 208927561 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11772 | $1628.00 | 1902875438 - CENTRAL PARK ENDOSCOPY CENTER LLC, ENDOSCOPY CENTER AT CENTRAL PARK | 752894418 - (TX) CENTRAL PARK ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11772 | $557.28 | 1568609378 - JEREMY LEE | 350593390 - DEACONESS HOSPITAL INC | SC | Certified Registered Nurse Anesthetist (367500000X) |
United | 11772 | $1212.93 | 1083838130 - PRASANNA YELAMANCHILI | 350593390 - DEACONESS HOSPITAL INC | IN | Cardiovascular Disease Physician (207RC0000X) |
United | 11772 | $1450.00 | 1093726796 - ROCKY MOUNTAIN EYE SURGERY CENTER INC | 810493712 - (MT) ROCKY MOUNTAIN EYE SURGERY CENTER INC | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11772 | $3930.00 | 1770566192 - SUMMERLIN BEND SURGERY CENTER LLP, ADULT & CHILDRENS SURGERY CENTER OF SOUTHWEST FLORIDA | 651005912 - (FL) SUMMERLIN BEND SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11772 | $1213.00 | 1316015738 - KRAMBERG OBS | 205126110 - (NJ) KRAMBERG OBS | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11772 | $1215.00 | 1376729715 - ENDOSCOPY ASSOCIATES OF VALLEY FORGE, LLC | 161770779 - (PA) ENDOSCOPY ASSOCIATES OF VALLEY FORGE LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11772 | $2200.00 | 1588312607 - JEWETT ORTHOPEDIC INSTITUTE SURGERY CENTER, LLC | 872667237 - (FL) JEWETT ORTHOPEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11772 | $746.00 | 1164601696 - SALVATORE DIMERCURIO MD PA | 521833726 - (MD) SALVATORE DIMERCURIO, M.D., P.A. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11772 | $4141.00 | 1487399168 - WILLOW PARK ENDOSCOPY CENTER, LLC | 881643733 - (TX) WILLOW PARK ENDOSCOPY CENTER LLC | TX | 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 11772 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11772 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 11772 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11772. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11772 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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