CPT 11057
Global 000Parng/cutg b9 hyprkr les >4
CPT 11057 Billing & Documentation Guide
CPT code 11057 (Parng/cutg b9 hyprkr les >4) is classified under Anesthesia with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.63, a non-facility practice expense RVU of 1.98, and a malpractice RVU of 0.05, a total non-facility RVU of 2.66 and facility RVU of 0.76. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $91.92, though rates vary from $78.71 to $119.62 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11057, 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 11057 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Restricted coverage (special situations)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 11057 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 11057
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.63 | 0.63 |
| Practice Expense RVU | 1.98 | 0.08 |
| Malpractice RVU | 0.05 | 0.05 |
| Total RVU | 2.66 | 0.76 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11057
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 | $100.96 | $25.86 | $94.78 - $119.62 | 29 |
| Florida | $90.65 | $26.98 | $86.78 - $94.11 | 3 |
| Georgia | $86.16 | $25.63 | $82.02 - $90.3 | 2 |
| Illinois | $88.21 | $26.89 | $84.03 - $92.07 | 4 |
| Michigan | $85.5 | $25.91 | $83.31 - $87.68 | 2 |
| North Carolina | $83.81 | $24.6 | $83.81 - $83.81 | 1 |
| New York | $98.09 | $27.29 | $85.04 - $104.12 | 5 |
| Ohio | $83.11 | $25.17 | $83.11 - $83.11 | 1 |
| Pennsylvania | $87.8 | $25.63 | $83.33 - $92.26 | 2 |
| Texas | $87.82 | $25.34 | $82.78 - $92.53 | 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 11057
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11057 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 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 |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 11057
What does CPT code 11057 mean? +
CPT code 11057 represents: Parng/cutg b9 hyprkr les >4. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 11057? +
The 2026 Medicare national average non-facility payment for CPT 11057 is $91.92. Rates range from $78.71 to $119.62 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11057? +
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 11057? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team