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See a sample rate comparisonCPT 11954 Fee Schedule
Last Verified: October 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.
Subcutaneous Injection Of Fil, Subcutaneous Injection Of Filling Material (Eg Collagen)5.1 To 10.0 Cc Subcutaneous Injection Of Filling Material (Eg Collagen) Filling Material (Eg Collagen)
| 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 79 - Unrelated procedure - postop period 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 11954 |
| Medicaid Fee Schedule | View Medicaid rates for 11954 |
National average reimbursement for CPT 11954 by major payers:
$187.30
$205.98
$204.73
$189.12
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CPT 11954
5 of 25 sample ratesHigher to lower in this preview
The Emory Clinic Inc., Emory Aesthetic Center
Emory University
$1,817.00Published rateAdvanced Surgery Center Of Sarasota, LLC
Advanced Surgery Center Of Sarasota LLC
$893.00Published rateUpper Valley Dialysis Access Center, LLC
Upper Valley Dialysis Access Center LLC
$410.00Published rateCardiovascular Institute Of The South Asc, LLC
Cardiovascular Institute Of The South Asc LLC
$326.00Published rateRegional Eye Associates, Inc, Surgical Eye Center Of Morgantown
Regional Eye Associates, Inc.
$150.00Published rate
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See a sample payer proposalCPT 11954 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11954 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 11954 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 |
|---|---|---|
| 11952-CPT | Low | Subcutaneous Injection Of Fil, Subcutaneous Injection Of Filling Material (Eg Collagen)5.1 To 10.0 Cc Subcutaneous Injection Of Filling Material (Eg Collagen) |
| 11954-CPT | Low | Subcutaneous Injection Of Fil, Subcutaneous Injection Of Filling Material (Eg Collagen)5.1 To 10.0 Cc Subcutaneous Injection Of Filling Material (Eg Collagen) Filling Material (Eg Collagen) |
| 11960-CPT | High | Insrt Of Tissue Expander(S) For Other Than Breast Inclu Subse, Insertion Of Tissue Expander(S) For Other Than Breast Including Subse |
| 11970-CPT | Moderate | Skin Prosthesis Placement, Surgery To Place A Permanent Prosthesis (Structure) Where A Tissue Expander Has Been Used To Prepare Tissue To Accept The Prosthesis. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11954. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11954 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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