CPT 11900 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 11900 by major payers:
$64.70
$69.26
$73.62
$92.27
| 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 11900 | ||||||
United | 11900 | $42.68 | 1659350247 - JONATHAN BASS | 341192978 - CLEVELAND SKIN PATHOLOGY LAB, INC. | OH | Dermatopathology Physician (207ND0900X) |
United | 11900 | $43.68 | 1912097775 - HALA KOUDSI | 330274949 - HALA KOUDSI, MD, INC. APC | CA | Specialist (174400000X) |
United | 11900 | $90.94 | 1710181201 - CASEY SHABA | 621483206 - (TN) HERITAGE MEDICAL ASSOCIATES, P.C. | TN | Dermatopathology Physician (207ND0900X) |
United | 11900 | $54.45 | 1770926255 - MATTHEW LIVINGOOD | 851465549 - (VA) ARLINGTON DERMATOLOGY PLLC | VA | Dermatology Physician (207N00000X) |
United | 11900 | $81.68 | 1841262177 - MARIAN RUSSO | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | Dermatology Physician (207N00000X) |
United | 11900 | $94.01 | 1851505077 - SHEREEN TIMANI-CHARKAWI | 263310765 - (GA) JOHNS CREEK DERMATOLOGY & FAMILY MEDICINE | GA | Dermatology Physician (207N00000X) |
United | 11900 | $61.93 | 1801835434 - MAX ADLER | 472727741 - (TX) LEGACY DERMATOLOGY PLLC | TX | Dermatology Physician (207N00000X) |
United | 11900 | $194.63 | 1659875540 - KELLY O'CONNOR | 43493375 - (MA) SOUTH SHORE SKIN CENTER, LLC | MA | Dermatology Physician (207N00000X) |
United | 11900 | $72.55 | 1306067814 - DANIEL LEVY | 263374369 - (WA) NEWVUE PLASTIC SURGERY, PC | WA | Dermatology Physician (207N00000X) |
United | 11900 | $189.16 | 1447661012 - EMILY GURNEE | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Dermatology Physician (207NP0225X) |
United | 11900 | $59.72 | 1972689164 - F REYNOLDS | 621054696 - (TN) CHATTANOOGA SKIN AND CANCER CLINIC, PC | TN | Dermatology Physician (207N00000X) |
United | 11900 | $136.42 | 1720512049 - JACK LEVY | 131623978 | NY | MOHS-Micrographic Surgery Physician (207ND0101X) |
United | 11900 | $55.54 | 1356521603 - MICHAEL ROSENBLUM | 943281660 | CA | Dermatology Physician (207N00000X) |
United | 11900 | $51.84 | 1740324862 - KARLA MUNOZ | 825046513 - (TX) KARLA N. MUNOZ MD PLLC | TX | Dermatology Physician (207N00000X) |
United | 11900 | $85.72 | 1801862271 - CAMERON ROKHSAR | 203387412 - (NY) CAMERON K ROKHSAR MD PC | NY | Dermatology Physician (207N00000X) |
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 11900 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11900 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 11900 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 |
|---|---|---|
| 11441 | Low | Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Face, Ears, Eyelids, Nose, Lips, Mucous Membrane; Excised Diameter 0.6 To 1.0 Cm |
| 11442 | Moderate | Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Face, Ears, Eyelids, Nose, Lips, Mucous Membrane; Excised Diameter 1.1 To 2.0 Cm |
| 11900 | Low | Inj Intralesional To 7 Les |
| 11901 | Low | Injection Intralesional 8or More |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11900. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11900 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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