CPT 11921 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 • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 11921 by major payers:
$246.56
$269.66
$289.42
$354.29
| 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 11921 | ||||||
United | 11921 | $82.00 | 1013011162 - BAY AREA ENDOSCOPY CENTER LIMITED PARTNERSHIP | 593213374 - (FL) BAY AREA ENDOSCOPY CENTER LIMITED PARTNERSHIP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $50.00 | 1609269232 - SURGICAL CENTER OF PONTE VEDRA BEACH LLC, PONTE VEDRA BEACH SURGERY CENTER | 472133947 - (FL) SURGICAL CENTER OF PONTE VEDRA B | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $531.00 | 1598083594 - MID-STATE ENDOSCOPY CENTER LLC | 270673692 - (TN) MIDSTATE ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $144.00 | 1073578019 - BLUE RIDGE DAY SURGERY CENTER, LP, BLUE RIDGE DAY SURGERY CENTER | 621530122 - (NC) BLUE RIDGE DAY SURGERY CENTER LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $112.00 | 1942292073 - SOUTHERN OKLAHOMA SURGICAL CENTER INC | 731205988 - (OK) SOUTHERN OKLAHOMA SURGICAL CENTER, INC. | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $315.00 | 1245343912 - WICHITA ENDOSCOPY CENTER LLC | 202572299 - (KS) WICHITA ENDOSCOPY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $914.00 | 1063442077 - INOVA LOUDOUN AMBULATORY SURGERY | 203523190 - (VA) INOVA LOUDOUN AMBULATORY SURGERY | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $410.00 | 1043239338 - NORTH VALLEY ENDOSCOPY CENTER LLC | 201729172 - (AZ) NORTH VALLEY ENDOSCOPY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $250.00 | 1760923445 - DIALYSIS ACCESS CENTER A MEDICAL CORPORATION | 522384032 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $241.00 | 1972874907 - CAPITAL CITY SURGERY CENTER, LLC | 260804803 - (NC) CAPITAL CITY SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $143.00 | 1538153887 - KANSAS ENDOSCOPY LLC | 200282684 - (KS) KANSAS ENDOSCOPY LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $550.00 | 1386161495 - MEDSTAR SURGERY CENTER AT BRANDYWINE, LLC | 820985178 - (MD) MEDSTAR SURGERY CENTER AT BRAN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $312.00 | 1306013925 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $300.00 | 1275598302 - WAUWATOSA SURGERY CENTER, LLC | 363469839 - (WI) WAUWATOSA SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $117.00 | 1881147965 - ULNA SURGERY CENTER LLC | 813050347 - (GA) ULNA SURGERY CENTER LLC | GA | 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 11921 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11921 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 11921 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 |
|---|---|---|
| 11442-CPT | 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 |
| 11443-CPT | Moderate | Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Face, Ears, Eyelids, Nose, Lips, Mucous Membrane; Excised Diameter 2.1 To 3.0 Cm |
| 11901-CPT | Low | Injection Intralesional 8or More |
| 11921-CPT | Moderate | Tattooing, Intradermal Introduction Of Insoluble Opaque Pigments To Correct Color Defects Of Skin, Including Micropigmentation; 6.0 - 20.0 Sq. Cm. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11921. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11921 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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