CPT 11602
Global 010 ActiveExc tr-ext mal+marg 1.1-2 cm
CPT 11602 Billing & Documentation Guide
CPT code 11602 (Exc tr-ext mal+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 2.21, a non-facility practice expense RVU of 4.76, and a malpractice RVU of 0.23, a total non-facility RVU of 7.2 and facility RVU of 4.09. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $247.83, though rates vary from $214.34 to $315.31 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11602, 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 11602 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 11602 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 11602
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.21 | 2.21 |
| Practice Expense RVU | 4.76 | 1.65 |
| Malpractice RVU | 0.23 | 0.23 |
| Total RVU | 7.2 | 4.09 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11602
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 | $268.75 | $145.84 | $253.44 - $315.31 | 29 |
| Florida | $248.29 | $144.07 | $237.36 - $258.75 | 3 |
| Georgia | $234.8 | $135.7 | $224.79 - $244.8 | 2 |
| Illinois | $242.38 | $142.01 | $230.98 - $251.75 | 4 |
| Michigan | $233.92 | $136.38 | $227.65 - $240.19 | 2 |
| North Carolina | $227.06 | $130.14 | $227.06 - $227.06 | 1 |
| New York | $265.13 | $149.24 | $230.26 - $281.84 | 5 |
| Ohio | $226.72 | $131.88 | $226.72 - $226.72 | 1 |
| Pennsylvania | $238.43 | $136.68 | $227.03 - $249.82 | 2 |
| Texas | $237.88 | $135.61 | $225.63 - $248.98 | 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 11602
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11602 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 |
| 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 |
Frequently Asked Questions, CPT 11602
What does CPT code 11602 mean? +
CPT code 11602 represents: Exc tr-ext mal+marg 1.1-2 cm. It's in the Anesthesia category with a global period of 010.
What is the Medicare reimbursement for CPT 11602? +
The 2026 Medicare national average non-facility payment for CPT 11602 is $247.83. Rates range from $214.34 to $315.31 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11602? +
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 11602? +
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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