CPT 11442
Global 010 ActiveExc face-mm b9+marg 1.1-2 cm
CPT 11442 Billing & Documentation Guide
CPT code 11442 (Exc face-mm 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 1.73, a non-facility practice expense RVU of 3.86, and a malpractice RVU of 0.22, a total non-facility RVU of 5.81 and facility RVU of 3.95. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $199.81, though rates vary from $172.32 to $253.99 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11442, 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 11442 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 11442 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 11442
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.73 | 1.73 |
| Practice Expense RVU | 3.86 | 2 |
| Malpractice RVU | 0.22 | 0.22 |
| Total RVU | 5.81 | 3.95 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11442
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 | $216.4 | $142.88 | $204.01 - $253.99 | 29 |
| Florida | $201.44 | $139.11 | $192.08 - $210.58 | 3 |
| Georgia | $189.66 | $130.39 | $181.55 - $197.77 | 2 |
| Illinois | $196.61 | $136.58 | $186.98 - $204.62 | 4 |
| Michigan | $189.19 | $130.86 | $183.79 - $194.59 | 2 |
| North Carolina | $182.77 | $124.81 | $182.77 - $182.77 | 1 |
| New York | $214.34 | $145.04 | $185.43 - $228.42 | 5 |
| Ohio | $182.9 | $126.18 | $182.9 - $182.9 | 1 |
| Pennsylvania | $192.44 | $131.59 | $183.08 - $201.8 | 2 |
| Texas | $191.86 | $130.69 | $181.93 - $200.81 | 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 11442
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11442 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00170 | 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 11442
What does CPT code 11442 mean? +
CPT code 11442 represents: Exc face-mm 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 11442? +
The 2026 Medicare national average non-facility payment for CPT 11442 is $199.81. Rates range from $172.32 to $253.99 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11442? +
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 11442? +
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 June 1, 2026.
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