Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 11980 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.
Implant Hormone Pellet, A Procedure To Insert One Or More Pellets Under The Skin That Contain Hormones Such As Estradiol Or Testosterone. This Is A Treatment For Controlling Menopause Symptoms.
| 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 | Low |
| Medicare Fee Schedule | View Medicare rates for 11980 |
| Medicaid Fee Schedule | View Medicaid rates for 11980 |
National average reimbursement for CPT 11980 by major payers:
$116.99
$125.05
$126.93
$102.83
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 11980.
CPT 11980
5 of 25 sample ratesHigher to lower in this preview
Northern Litho Inc
Northern Litho, Inc.
$2,100.00Published rateSummit Ambulatory Surgical Center, LLC
$665.00Published ratePremier Ambulatory Surgery Center
$350.00Published rateCentral Texas Endoscopy Center LLC, Central Texas Endoscopy Center
Central Texas Endoscopy Center LLC
$163.00Published rateAmerican Access Care Of Atlanta Asc LLC, Institute For Minimally Invasive Therapies Surgery Center
American Access Care Of Atlanta Asc LLC
$79.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 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-CPT | Low | Removal Implantable Contracep, Removal Implantable Contraceptive Capsulesremoval Implantable Contraceptive Capsules |
| 11980-CPT | Low | Implant Hormone Pellet, A Procedure To Insert One Or More Pellets Under The Skin That Contain Hormones Such As Estradiol Or Testosterone. This Is A Treatment For Controlling Menopause Symptoms. |
| 11981-CPT | Low | Implant Drug Delivery Unit, Procedure To Implant (Insert Under The Skin) A Nonbiodegradable Device That Dispenses A Drug Automatically. |
| 11982-CPT | Low | Remove Drug Delivery Unit, Procedure To Remove A Nonbiodegradable Device For Dispensing A Drug That Had Been Inserted Under The Skin. |
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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 11980) and we'll show you how you compare in 15 minutes or less.