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See a sample rate comparisonCPT 11971 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.
Removal Of Tissue Expander, Surgery To Remove A Tissue Expander Without Replacing It With A Prosthesis (Structure).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 11971 |
| Medicaid Fee Schedule | View Medicaid rates for 11971 |
National average reimbursement for CPT 11971 by major payers:
$690.33
$608.77
$691.96
$726.94
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CPT 11971
5 of 25 sample ratesHigher to lower in this preview
Central Louisiana Ambulatory Surgical Center LLC
Central Louisiana Surgical Hospital, LLC
$4,111.00Published rateHarbor Heights Surgery Center, LLC
Harbor Heights Surgery Center LLC
$2,859.00Published rateAthens Orthopedic Clinic Ambulatory Surgery Center, LLC
Athens Orthopedic Clinic Ambulatory Surgery Center LLC
$1,597.00Published rateEssex Endoscopy Center LLC
$1,050.00Published rateSurgery Center At Gateway LLC
$490.00Published rate
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See a sample payer proposalCPT 11971 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11971 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 11971 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 |
|---|---|---|
| 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. |
| 11971-CPT | Moderate | Removal Of Tissue Expander, Surgery To Remove A Tissue Expander Without Replacing It With A Prosthesis (Structure). |
| 11981-CPT | Low | Implant Drug Delivery Unit, Procedure To Implant (Insert Under The Skin) A Nonbiodegradable Device That Dispenses A Drug Automatically. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11971. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11971 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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