CPT 11012
Global 000 ActiveDeb skin bone at fx site
CPT 11012 Billing & Documentation Guide
CPT code 11012 (Deb skin bone at fx site) is classified under Anesthesia with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 6.7, a non-facility practice expense RVU of 12.54, and a malpractice RVU of 1.32, a total non-facility RVU of 20.56 and facility RVU of 10.85. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $703.22, though rates vary from $606.28 to $876.01 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11012, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 11012 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 11012 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 11012
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 6.7 | 6.7 |
| Practice Expense RVU | 12.54 | 2.83 |
| Malpractice RVU | 1.32 | 1.32 |
| Total RVU | 20.56 | 10.85 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11012
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $751.33 | $367.56 | $710.28 - $876.01 | 29 |
| Florida | $729.86 | $404.45 | $690.47 - $771.31 | 3 |
| Georgia | $676.46 | $367.06 | $649.95 - $702.96 | 2 |
| Illinois | $713.54 | $400.16 | $675.11 - $747.48 | 4 |
| Michigan | $679.14 | $374.6 | $655.97 - $702.31 | 2 |
| North Carolina | $642.74 | $340.15 | $642.74 - $642.74 | 1 |
| New York | $761.6 | $399.79 | $652.69 - $817.99 | 5 |
| Ohio | $650.64 | $354.53 | $650.64 - $650.64 | 1 |
| Pennsylvania | $683.19 | $365.52 | $649.95 - $716.43 | 2 |
| Texas | $678.33 | $359.03 | $645.9 - $706.44 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 11012
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11012 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0183T | Column 1 (primary), can be billed with modifier | Yes | More extensive procedure |
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0334T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0335T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0479T | Column 1 (primary), can be billed with modifier | Yes | More extensive procedure |
| 0491T | Column 1 (primary), can be billed with modifier | Yes | More extensive procedure |
Frequently Asked Questions, CPT 11012
What does CPT code 11012 mean? +
CPT code 11012 represents: Deb skin bone at fx site. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 11012? +
The 2026 Medicare national average non-facility payment for CPT 11012 is $703.22. Rates range from $606.28 to $876.01 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11012? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 11012? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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