CPT 11921
Global 000Correct skn color 6.1-20.0cm
CPT 11921 Billing & Documentation Guide
CPT code 11921 (Correct skn color 6.1-20.0cm) is classified under Anesthesia with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.88, a non-facility practice expense RVU of 4.76, and a malpractice RVU of 0.35, a total non-facility RVU of 6.99 and facility RVU of 3.47. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $240.01, though rates vary from $205.39 to $305.23 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11921, 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 11921 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 11921 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 11921
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.88 | 1.88 |
| Practice Expense RVU | 4.76 | 1.24 |
| Malpractice RVU | 0.35 | 0.35 |
| Total RVU | 6.99 | 3.47 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11921
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 | $259.51 | $120.39 | $244.38 - $305.23 | 29 |
| Florida | $245.07 | $127.11 | $232.36 - $257.87 | 3 |
| Georgia | $228.55 | $116.38 | $218.55 - $238.55 | 2 |
| Illinois | $238.98 | $125.37 | $226.22 - $249.85 | 4 |
| Michigan | $228.54 | $118.14 | $221.15 - $235.93 | 2 |
| North Carolina | $218.6 | $108.91 | $218.6 - $218.6 | 1 |
| New York | $259.03 | $127.87 | $222.05 - $277.56 | 5 |
| Ohio | $219.73 | $112.39 | $219.73 - $219.73 | 1 |
| Pennsylvania | $231.58 | $116.43 | $219.79 - $243.38 | 2 |
| Texas | $230.52 | $114.77 | $218.33 - $241.49 | 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 11921
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11921 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 11921
What does CPT code 11921 mean? +
CPT code 11921 represents: Correct skn color 6.1-20.0cm. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 11921? +
The 2026 Medicare national average non-facility payment for CPT 11921 is $240.01. Rates range from $205.39 to $305.23 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11921? +
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 11921? +
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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