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 | $129.00 | 1073620415 - NORTH BAY EYE ASSOCIATES A MEDICAL CORPORATION, NORTH BAY EYE ASSOCIATES ASC | 680368973 - (CA) NORTH BAY EYE ASSOCIATES | CA | 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 | $410.00 | 1043239338 - NORTH VALLEY ENDOSCOPY CENTER LLC | 201729172 - (AZ) NORTH VALLEY ENDOSCOPY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $350.00 | 1518967082 - NOVAMED SURGERY CENTER OF OAK LAWN, LLC, CENTER FOR RECONSTRUCTIVE SURGERY OF OAK LAWN | 770618674 - (IL) NOVAMED SURGERY CENTER OF OAK LAWN LLC | IL | 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 | $301.00 | 1578892600 - THE RYE AMBULATORY SURGERY CENTER, LLC | 262335845 - (NY) THE RYE AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $1125.00 | 1902401748 - LANDMARK SURGICAL SUITES, LLC | 851130696 - (IN) LANDMARK SURGICAL SUITES LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $151.00 | 1235683798 - ASSOCIATED SURGICAL CENTER LLC | 813492018 - (IL) ASSOCIATED SURGICAL CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $395.00 | 1831686674 - CASTLE ROCK SURGICENTER, LLC | 825207935 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $328.00 | 1952312399 - ZITELLI & BRODLAND PC, ZITELLI & BRODLAND ASF SOUTH | 251549973 - JOHN A. ZITELLI, MD, PC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $400.00 | 1245862002 - QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC, QUINCY MEDICAL GROUP SURGERY CENTER | 371206525 - QUINCY PHYSICIANS & SURGEONS CLINIC S.C. D/B/A QUINCY MEDICAL GROUP | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $240.00 | 1750874400 - DENVER DIAGNOSTIC ASC, LLC | 825510334 - (CO) DENVER DIAGNOSTIC ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $164.00 | 1780752352 - PREMIER SURGERY CENTER OF SANTA MARIA LLC | 203502741 - (CA) PREMIER SURGERY CENTER OF SANTA MARIA, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $178.00 | 1750927190 - HERMITAGE ENDOSCOPY CENTER INC | 841815468 - (PA) HERMITAGE ENDOSCOPY CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11921 | $149.00 | 1811095136 - GROSSMONT OUTPATIENT SURGICAL CENTER | 953337109 - (CA) GROSSMONT OUTPATIENT SURGICAL CE | CA | 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 | 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 | 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 | Low | Injection Intralesional 8or More |
| 11921 | 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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