CPT 11402
Global 010 ActiveExc tr-ext b9+marg 1.1-2 cm
CPT 11402 Billing & Documentation Guide
CPT code 11402 (Exc tr-ext b9+marg 1.1-2 cm) is classified under Anesthesia with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.41, a non-facility practice expense RVU of 3.53, and a malpractice RVU of 0.18, a total non-facility RVU of 5.12 and facility RVU of 3.07. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $176.25, though rates vary from $151.47 to $225.52 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11402, 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 11402 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 3 units of 11402 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 11402
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.41 | 1.41 |
| Practice Expense RVU | 3.53 | 1.48 |
| Malpractice RVU | 0.18 | 0.18 |
| Total RVU | 5.12 | 3.07 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11402
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 | $191.56 | $110.54 | $180.34 - $225.52 | 29 |
| Florida | $177.1 | $108.4 | $168.85 - $185.04 | 3 |
| Georgia | $166.84 | $101.52 | $159.43 - $174.25 | 2 |
| Illinois | $172.68 | $106.51 | $164.14 - $179.72 | 4 |
| Michigan | $166.27 | $101.98 | $161.53 - $171.01 | 2 |
| North Carolina | $160.94 | $97.06 | $160.94 - $160.94 | 1 |
| New York | $189.04 | $112.65 | $163.33 - $201.46 | 5 |
| Ohio | $160.8 | $98.29 | $160.8 - $160.8 | 1 |
| Pennsylvania | $169.43 | $102.37 | $161.01 - $177.85 | 2 |
| Texas | $169.02 | $101.61 | $159.97 - $177.26 | 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 11402
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11402 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00400 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical 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 |
| 0470T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0471T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 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 |
Frequently Asked Questions, CPT 11402
What does CPT code 11402 mean? +
CPT code 11402 represents: Exc tr-ext b9+marg 1.1-2 cm. It's in the Anesthesia category with a global period of 010.
What is the Medicare reimbursement for CPT 11402? +
The 2026 Medicare national average non-facility payment for CPT 11402 is $176.25. Rates range from $151.47 to $225.52 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11402? +
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 11402? +
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