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CPT 11772 Fee Schedule

Last Verified: January 2026

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.

Exc Pilonidal Cyst/Sinus Complic
Key FactDetail
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 LevelModerate

National average reimbursement for CPT 11772 by major payers:

bcbs

$833.53

uhc

$892.21

aetna

$968.64

cigna

$1,203.22

Preview provider-level rates for...
For billing codeCPT 11772
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 11772

United
11772$743.001972568830 - FLORENCE SURGERY CENTER, L.P., FLORENCE SURGERY CENTER621551098 - (AL) FLORENCE SURGERY CENTER LPALAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$5729.001003127606 - MEMORIAL HERMANN ENDOSCOPY CENTER NORTH FREEWAY LLC, MEMORIAL HERMANN ENDOSCOPY CENTER NORTH LOOP272800702TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$1645.001457378333 - BEAUMONT SURGICAL AFFILIATES, LTD, BAPTIST BEAUMONT SURGICAL AFFILIATES821773443 - (TX) BEAUMONT SURGICAL AFFILIATESTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$1450.001093726796 - ROCKY MOUNTAIN EYE SURGERY CENTER INC810493712 - (MT) ROCKY MOUNTAIN EYE SURGERY CENTER INCMTAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$719.001477917151 - WHITE OAK SURGERY CENTER273885555 - (GA) WHITE OAK SURGERY CENTERGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$2307.001295479780 - ADVENTHEALTH SURGERY CENTER DAVENPORT LLC881811228FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$520.001437636636 - CCRM DFW, LLC, CCRM DALLAS FORT WORTH822959456TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$1190.001134182546 - JACKSONVILLE SURGERY CENTER, LTD621600402 - (FL) JACKSONVILLE SURGERY CENTER LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$1628.001902875438 - CENTRAL PARK ENDOSCOPY CENTER LLC, ENDOSCOPY CENTER AT CENTRAL PARK752894418 - (TX) CENTRAL PARK ENDOSCOPY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$1457.001306274097 - INTERVENTIONAL PAIN MANAGEMENT LLC452192531 - (IN) INTERVENTIONAL PAIN MANAGEMENT LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$776.001396738936 - WARREN GASTRO ENDOSCOPY CTR INC341850936 - (OH) WARREN GASTRO ENDOSCOPY CTR INCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$1215.001376729715 - ENDOSCOPY ASSOCIATES OF VALLEY FORGE, LLC161770779 - (PA) ENDOSCOPY ASSOCIATES OF VALLEY FORGE LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$1385.001841286267 - SURGERY CENTER OF SOUTHERN OREGON, LLC931189291 - (OR) SURGERY CENTER OF SOUTHERN OREGON, L.L.C.ORAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$1320.001508869645 - FRESNO CA ENDOSCOPY ASC, LP, CENTRAL CALIFORNIA ENDOSCOPY CENTER912127626 - (CA) FRESNO CA ENDOSCOPY ASC LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
11772$1207.001629145685 - IDAHO EYE CENTER PA, IDAHO EYE SURGICENTER820379995 - (ID) IDAHO EYE CENTER, P.A.IDAmbulatory 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 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.

CodeComplexityDescription
11719-CPTLowTrimming Of Nondysrophic Nails, Any Number
11720-CPTLowDebridement Of Nail(S) By Any Method(S); One To Five
11765-CPTLowWedge Exc Skin Nail Fold (Ingrown)
11772-CPTModerateExc Pilonidal Cyst/Sinus Complic

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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