CPT 11980 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 • GA - Required ABN issued and on file • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 11980 by major payers:
$116.99
$125.05
$126.93
$158.20
| 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 11980 | ||||||
United | 11980 | $2100.00 | 1871519314 - NORTHERN LITHO INC | 161511455 - (FL) NORTHERN LITHO, INC. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $245.00 | 1215919113 - VISION INSTITUTE OF MICHIGAN SURGERY CENTER PC, SURGERY CENTER OF MICHIGAN | 382945641 | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $275.00 | 1275132094 - COASTAL CARDIOVASCULAR CENTER, LLC, COASTAL CARDIOVASCULAR CENTER | 845144651 - (TX) COASTAL CARDIOVASCULAR CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $506.00 | 1356704027 - GLEN ECHO SURGERY CENTER, LLC | 474049838 - (MD) GLEN ECHO SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $163.00 | 1003887225 - CENTRAL TEXAS ENDOSCOPY CENTER LLC, CENTRAL TEXAS ENDOSCOPY CENTER | 742863853 - (TX) CENTRAL TEXAS ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $225.00 | 1285936641 - RIVERS EDGE AESTHETIC SURGERY, LLC | 271645468 - (SD) RIVERS EDGE AESTHETIC SURGERY LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $1096.00 | 1063598597 - CLEAR CREEK SURGERY CENTER LLC | 200871085 - (CO) CLEAR CREEK SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $125.00 | 1578722633 - GREENVILLE SURGERY CENTER LP, PIEDMONT SURGERY CENTER | 570965527 - (SC) GREENVILLE SURGERY CENTER LIMITED PARTNERSHIP | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $531.00 | 1053574244 - SURGERY CENTER AT UNIVERSITY PARK, LLC, PREMIER SURGERY CENTER OF SARASOTA | 203757623 - (FL) SURGERY CENTER AT UNIVERSITY PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $129.00 | 1891295275 - FRESENIUS VASCULAR CARE MONTGOMERY ASC LLC | 815391782 - (AL) FRESENIUS VASCULAR CARE MONTGOMERY ASC LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $388.00 | 1447301593 - 481 ASC PROJECT LLC, EYE MD LASER & SURGERY CENTER LLC | 943272782 - (CA) 481 ASC PROJECT LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $911.00 | 1740918887 - ORTHOMIDWEST SURGERY CENTER BELOIT, LLC | 881260648 - (WI) ORTHOMIDWEST SURGERY CENTER BELOIT LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $76.47 | 1992203152 - CHRISTOPHER SANTOS | 350593390 - DEACONESS HOSPITAL INC | SC | Certified Registered Nurse Anesthetist (367500000X) |
United | 11980 | $152.00 | 1861497380 - NORTHEAST NEBRASKA SURGERY CENTER LLC, FAITH REGIONAL SURGERY CENTER | 470819088 - (NE) NORTHEAST NEBRASKA SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 11980 | $76.47 | 1649606815 - AMANDA ROMERHAUSEN | 350593390 - DEACONESS HOSPITAL INC | IN | Acute Care Nurse Practitioner (363LA2100X) |
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 11980 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11980 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 11980 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 | Low | Removal Without Reinsertion, Implantable Contraceptive Capsules |
| 11980 | Low | Subcutaneous Hormone Pellet Implantation (Implantation Of Estradiol And/Or Testosterone Pellets Beneath The Skin) |
| 11981 | Low | Insertion Drug Delivery Implant(Ie Bioresorbable Biodegradable Non-Biodegradable) (Desc Rvsd 1/1/22) |
| 11982 | 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 11980. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11980 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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