CPT 11976 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 • 50 - Federally Qualified Health Center |
| Common Modifiers | • None • UA • AG - Primary physician |
| Complexity Level | Low |
National average reimbursement for CPT 11976 by major payers:
$164.10
$185.67
$188.49
$236.39
| 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 11976 | ||||||
United | 11976 | $430.00 | 1518279504 - EVANS PROCEDURE CENTER, LLC | 272289325 - (GA) EVANS PROCEDURE CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $420.00 | 1063466118 - VALLEY SURGICAL CENTER INC | 204211574 - (PA) VALLEY SURGICAL CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $290.00 | 1124777321 - VIRGINIA CARDIOVASCULAR SPECIALISTS, VCS HEART AND VASCULAR CENTER | 541090122 - (VA) VIRGINIA CARDIOVASCULAR SPECIALISTS PC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $380.00 | 1164476933 - NOVAMED SURGERY CENTER OF SAN ANTONIO LP, AMERICAN SURGERY CENTER | 204400460 - (TX) NOVAMED SURGERY CENTER OF SAN ANTONIO LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $1349.00 | 1508169921 - SAINT LUKES-GI DIAGNOSTICS LLC | 274142549 - (MO) SAINT LUKESGI DIAGNOSTICS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $1062.00 | 1669574539 - MANCHESTER SURGERY CENTER, LLC | 205953313 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $650.00 | 1164460812 - BLUEGRASS ORTHOPAEDICS SURGICAL DIVISION LLC | 203916788 - (KY) BLUEGRASS SPECIALTY SURGERY CENTER, LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $1013.00 | 1689852618 - MILLARD FILLMORE SURGERY CENTER, LLC | 261582864 - (NY) MILLARD FILLMORE SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $352.00 | 1902958226 - AMBULATORY SURGERY CENTER OF TUCSON, INC. | 262420656 - (AZ) AMBULATORY SURGERY CENTER OF TUCSON INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $675.00 | 1275158495 - BCC CHANDLER LLC | 851284830 - (AZ) BCC CHANDLER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $320.00 | 1467783688 - PREMIER SURGICAL CENTER LLC | 261807944 - (FL) PREMIER SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $351.00 | 1639664089 - AIKEN REGIONAL MEDICAL CENTERS SURGERY CENTER LLC | 830879278 | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $340.00 | 1255342366 - MILLMAN-DERR CENTER FOR EYE CARE, P.C., MD SURGICENTER | 382184165 - (MI) MILLMAN-DERR CENTER FOR EYE CARE, P.C. | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $326.00 | 1841290103 - CENTRAL FLORIDA EYE INSTITUTE PL | 421621290 - (FL) CENTRAL FLORIDA EYE INSTITUTE PL | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11976 | $503.00 | 1053510933 - MONTGOMERY EYE SURGERY CENTER LLC, MONTGOMERY EYE SURGERY CENTER | 621607284 - (AL) MONTGOMERY EYE SURGERY CENTER LLC | AL | 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 11976 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11976 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 11976 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 |
|---|---|---|
| 11976-CPT | Low | Removal Without Reinsertion, Implantable Contraceptive Capsules |
| 11980-CPT | Low | Subcutaneous Hormone Pellet Implantation (Implantation Of Estradiol And/Or Testosterone Pellets Beneath The Skin) |
| 11981-CPT | Low | Insertion Drug Delivery Implant(Ie Bioresorbable Biodegradable Non-Biodegradable) (Desc Rvsd 1/1/22) |
| 11982-CPT | Low | Removal, Non-Biodegradable Drug Delivery Implant |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11976. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11976 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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