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11005 Dbrdmt skin abdominal wall

What 11005 is

CMS fee schedule short descriptor: Dbrdmt skin abdominal wall.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 11005 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)13.883.413.4520.74$692.73
Facility (hospital, ASC)13.883.413.4520.74$692.73

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply (endoscopic or minor procedure: global period is the day of the procedure).

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Medically Unlikely Edit (MUE)

Medicare caps 11005 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 11005? These codes are bundled into it

11005 is a Column 1 code in 244 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0437TImpltj synth rnfcmt abdl wal1 - modifier may bypassCheck pair
0552TLow-level laser therapy1 - modifier may bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
10030Img gid flu coll drg sft tis1 - modifier may bypassCheck pair
10060I&d abscess simple/single1 - modifier may bypassCheck pair
10061I&d abscess comp/multiple1 - modifier may bypassCheck pair
11000Dbrdmt ecz/infected skin<10%1 - modifier may bypassCheck pair
11004Dbrdmt skin xtrnl gent&per0 - no modifier bypassCheck pair
11010Debride skin at fx site1 - modifier may bypassCheck pair
11011Debride skin musc at fx site1 - modifier may bypassCheck pair
11012Deb skin bone at fx site1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair
11043Dbrdmt musc&/fsca 1st 20/<1 - modifier may bypassCheck pair
11044Dbrdmt bone 1st 20 sq cm/<1 - modifier may bypassCheck pair
11102Tangntl bx skin single les1 - modifier may bypassCheck pair
11103Tangntl bx skin ea sep/addl1 - modifier may bypassCheck pair
11104Punch bx skin single lesion1 - modifier may bypassCheck pair
11105Punch bx skin ea sep/addl1 - modifier may bypassCheck pair
11106Incal bx skn single les1 - modifier may bypassCheck pair
11107Incal bx skn ea sep/addl1 - modifier may bypassCheck pair
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair

Showing 30 of 244 column 2 codes. Use the pair checker for any specific combination.

11005 is bundled into these codes

11005 appears as a Column 2 code in 3033 active edits. Reported with one of these Column 1 codes on the same date of service, 11005 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0100TProsth retina receive&gen1Check pair
0164TRemove lumb artif disc addl1Check pair
0165TRevise lumb artif disc addl1Check pair
0184TExc rectal tumor endoscopic1Check pair
0200TPerq sacral augmt unilat inj1Check pair
0201TPerq sacral augmt bilat inj1Check pair
0202TPost vert arthrplst 1 lumbar1Check pair
0234TTrluml perip athrc renal art1Check pair
0235TTrluml perip athrc visceral1Check pair
0236TTrluml perip athrc abd aorta1Check pair
0237TTrluml perip athrc brchiocph1Check pair
0238TTrluml perip athrc iliac art1Check pair
0253TInsert aqueous drain device1Check pair
0308TInsj ocular telescope prosth1Check pair
0402TColgn crs-link crn&pachymtry1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.