CPT 11200Surgery

Rmvl skin tags up to&inc 15

CPT code 11200 covers the removal of skin tags (small, harmless skin growths) when a physician removes up to 15 lesions in a single session. This is a common outpatient procedure typically performed in a dermatology or primary care office.

Showing rates for

National Average

Base Medicare rate

$90.25

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.82

PE RVU (NF)

1.89

MP RVU

0.08

Total RVU

2.79

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Document the exact number of skin tags removed (1-15 for code 11200) in the operative note and charge capture
Impact: Prevents automatic denials; undocumented lesion counts result in 15-25% denial rate for this code
Bill 11200 only once per session regardless of anatomic sites; use 11201 for each additional 10 lesions beyond the first 15
Impact: Correct add-on coding increases reimbursement by $45-60 per additional 10 lesions removed
Verify medical necessity by documenting symptoms (bleeding, irritation, pain) rather than cosmetic reasons in clinical notes
Impact: Medical necessity documentation reduces denial rate from 40% to under 5%; cosmetic removals are patient-pay
When billing with an E/M on the same day, append modifier 25 to the E/M code (not to 11200) and document separate reason for visit
Impact: Proper modifier placement ensures E/M reimbursement of $75-150 is not bundled into the procedure
Use non-facility rate ($90.25) for office settings and facility rate ($75.37) for hospital outpatient departments or ASCs
Impact: Billing location accuracy prevents $14.88 overpayment recoupment per claim
Avoid billing 11200 with destructions codes (17000-17004) for the same lesions; these are mutually exclusive procedures
Impact: Prevents NCCI bundling denials that require time-consuming appeals and delay payment 30-60 days

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 11200 in 2025?

The 2025 Medicare national average reimbursement for CPT 11200 is $90.25 in non-facility settings (office) and $75.37 in facility settings (hospital outpatient or ASC). Actual rates may vary by geographic locality based on the GPCI adjustment factors.

How many skin tags can be removed under CPT code 11200?

CPT 11200 covers removal of up to 15 skin tags in a single session. If more than 15 lesions are removed, you must also bill add-on code 11201 for each additional 10 lesions (e.g., 16-25 lesions = 11200 + one unit of 11201; 26-35 lesions = 11200 + two units of 11201).

Does Medicare cover skin tag removal as medically necessary?

Medicare covers skin tag removal under 11200 only when medically necessary, such as when lesions are bleeding, painful, repeatedly traumatized, or interfering with daily activities. Removal for purely cosmetic reasons is not covered and is patient responsibility. Documentation must clearly establish medical necessity.

Can I bill an office visit with CPT 11200 on the same day?

Yes, you can bill an E/M service with 11200 on the same day if a separately identifiable evaluation and management service is performed. Append modifier 25 to the E/M code and document a distinct reason for the visit beyond the decision to remove the skin tags (such as evaluation of other conditions or a comprehensive assessment preceding the decision for removal).

What is the difference between CPT 11200 and 17000 for skin tag removal?

CPT 11200 is used for surgical removal of skin tags (scissors excision, electrosurgical destruction with removal of tissue). CPT 17000 is for destruction of premalignant lesions and should not be used for benign skin tags. For simple cryotherapy or chemical destruction of skin tags without tissue removal, some payers may allow 17110-17111 series, but 11200 is the most appropriate code for most skin tag removal methods.

How do I bill for skin tag removal in multiple locations on the same day?

Bill CPT 11200 only once per session regardless of how many different body areas are treated. Count the total number of skin tags removed across all locations; if 15 or fewer, use only 11200. If more than 15, add code 11201 for each additional 10 lesions. Do not bill 11200 multiple times for different anatomic sites.

What RVU value does CPT 11200 have for 2025?

For 2025, CPT 11200 has a work RVU of 0.82, non-facility practice expense RVU of 1.89, facility practice expense RVU of 1.43, and malpractice RVU of 0.08, for a total non-facility RVU of 2.79. These values multiplied by the 2025 conversion factor of 32.3465 determine Medicare reimbursement rates.