CPT 11950 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 • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Moderate |
National average reimbursement for CPT 11950 by major payers:
$98.22
$98.93
$103.61
$129.24
| 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 11950 | ||||||
United | 11950 | $89.00 | 1568083103 - COLUMBIA PARKWAY SURGERY CENTER LLC | 850692755 - (MD) COLUMBIA PARKWAY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $200.00 | 1043680440 - SOUTHWEST MEDICAL ASSOCIATES, INC, SOUTHWEST MEDICAL ASSOCIATES - TENAYA | 880201420 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $76.00 | 1215957816 - SURGERY CENTER OF CENTRAL VIRGINIA INC., D.B.A. EYE SURGERY CENTER | 541816412 - (VA) SURGERY CENTER OF CENTRAL VIRGINIA INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $230.00 | 1881339133 - BSC SHEA PARK LLC | 881850069 - (AZ) BSC SHEA PARK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $705.00 | 1154199859 - WATSON CLINIC ASC, LLC | 934728316 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $971.00 | 1467511899 - MERCY TERRACE HILL SURGERY CENTER, LLC, MERCY RIVER HILLS SURGERY CENTER | 421473103 - (IA) MERCY TERRACE HILL SURGERY CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $125.00 | 1699082875 - PAIN CONSULTANTS ASC LLC | 204929098 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $373.00 | 1255332805 - PRAIRIELAND OUTPATIENT DIAGNOSTIC CENTER LLC, DIGESTIVE DISEASE ENDOSCOPY CENTER | 50540368 - (IL) PRAIRIELAND OUTPATIENT DIAGNOSTIC CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $395.00 | 1881020899 - SURGCENTER OF CASTLE ROCK LLC | 825207935 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $83.00 | 1316969058 - BETHESDA ENDOSCOPY CENTER, LLC | 521915901 - (MD) BETHESDA ENDOSCOPY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $557.00 | 1598729329 - SURGICARE OF ST ANDREWS LTD | 611276561 - (FL) SURGICARE OF ST ANDREWS LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $132.00 | 1295714301 - ENDOSCOPY CENTER OF SOUTHEAST TEXAS LP, ENDOSCOPY CENTER OF SOUTHEAST TEXAS | 621536529 - (TX) ENDOSCOPY CENTER OF SOUTHEAST TEXAS LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $1028.00 | 1699742676 - PARKWAY SURGERY CENTER, LTD | 364581088 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $2347.00 | 1356124309 - SAINT LUKE'S NORTH SURGERY CENTER, LLC | 920591506 - (MO) SAINT LUKES NORTH SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11950 | $75.00 | 1881728590 - SYSTEM OPTICS LLC | 341572960 - (OH) SYSTEM OPTICS, INC. | OH | 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 11950 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11950 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 11950 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 |
| 11950 | Low | Injection Subcutan Filler Under 1cc |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11950. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11950 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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