CPT 11920
Global 000Correct skin color 6.0 cm/<
CPT 11920 Billing & Documentation Guide
CPT code 11920 (Correct skin color 6.0 cm/<) is classified under Anesthesia with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.57, a non-facility practice expense RVU of 4.63, and a malpractice RVU of 0.28, a total non-facility RVU of 6.48 and facility RVU of 3.07. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $222.91, though rates vary from $190.1 to $286.22 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11920, 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 11920 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 11920 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 11920
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.57 | 1.57 |
| Practice Expense RVU | 4.63 | 1.22 |
| Malpractice RVU | 0.28 | 0.28 |
| Total RVU | 6.48 | 3.07 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11920
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 | $242.38 | $107.61 | $227.84 - $286.22 | 29 |
| Florida | $225.81 | $111.53 | $214.34 - $237.08 | 3 |
| Georgia | $211.24 | $102.59 | $201.53 - $220.95 | 2 |
| Illinois | $219.92 | $109.87 | $208.25 - $229.69 | 4 |
| Michigan | $210.82 | $103.87 | $204.19 - $217.44 | 2 |
| North Carolina | $202.7 | $96.43 | $202.7 - $202.7 | 1 |
| New York | $240.16 | $113.1 | $205.93 - $257.04 | 5 |
| Ohio | $203.06 | $99.07 | $203.06 - $203.06 | 1 |
| Pennsylvania | $214.39 | $102.82 | $203.24 - $225.53 | 2 |
| Texas | $213.67 | $101.53 | $201.86 - $224.45 | 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 11920
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11920 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 11920
What does CPT code 11920 mean? +
CPT code 11920 represents: Correct skin color 6.0 cm/<. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 11920? +
The 2026 Medicare national average non-facility payment for CPT 11920 is $222.91. Rates range from $190.1 to $286.22 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11920? +
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 11920? +
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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