CPT 11950
Global 000Subq njx filling matrl 1cc/<
CPT 11950 Billing & Documentation Guide
CPT code 11950 (Subq njx filling matrl 1cc/<) is classified under Anesthesia with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.82, a non-facility practice expense RVU of 1.67, and a malpractice RVU of 0.15, a total non-facility RVU of 2.64 and facility RVU of 1.33. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $90.45, though rates vary from $77.88 to $113.52 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11950, 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 11950 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 11950 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 11950
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.82 | 0.82 |
| Practice Expense RVU | 1.67 | 0.36 |
| Malpractice RVU | 0.15 | 0.15 |
| Total RVU | 2.64 | 1.33 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11950
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 | $97.09 | $45.32 | $91.67 - $113.52 | 29 |
| Florida | $93.11 | $49.21 | $88.24 - $98.13 | 3 |
| Georgia | $86.64 | $44.9 | $83.12 - $90.16 | 2 |
| Illinois | $90.96 | $48.68 | $86.15 - $95.14 | 4 |
| Michigan | $86.82 | $45.73 | $83.97 - $89.66 | 2 |
| North Carolina | $82.63 | $41.81 | $82.63 - $82.63 | 1 |
| New York | $97.73 | $48.91 | $83.9 - $104.77 | 5 |
| Ohio | $83.37 | $43.42 | $83.37 - $83.37 | 1 |
| Pennsylvania | $87.63 | $44.77 | $83.33 - $91.93 | 2 |
| Texas | $87.11 | $44.03 | $82.8 - $90.9 | 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 11950
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11950 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 11950
What does CPT code 11950 mean? +
CPT code 11950 represents: Subq njx filling matrl 1cc/<. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 11950? +
The 2026 Medicare national average non-facility payment for CPT 11950 is $90.45. Rates range from $77.88 to $113.52 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11950? +
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 11950? +
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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