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 RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 13.88 | 3.41 | 3.45 | 20.74 | $692.73 |
| Facility (hospital, ASC) | 13.88 | 3.41 | 3.45 | 20.74 | $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).
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 code | Short description | Modifier indicator | |
|---|---|---|---|
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0437T | Impltj synth rnfcmt abdl wal | 1 - modifier may bypass | Check pair |
0552T | Low-level laser therapy | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
10030 | Img gid flu coll drg sft tis | 1 - modifier may bypass | Check pair |
10060 | I&d abscess simple/single | 1 - modifier may bypass | Check pair |
10061 | I&d abscess comp/multiple | 1 - modifier may bypass | Check pair |
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11004 | Dbrdmt skin xtrnl gent&per | 0 - no modifier bypass | Check pair |
11010 | Debride skin at fx site | 1 - modifier may bypass | Check pair |
11011 | Debride skin musc at fx site | 1 - modifier may bypass | Check pair |
11012 | Deb skin bone at fx site | 1 - modifier may bypass | Check pair |
11042 | Dbrdmt subq tis 1st 20sqcm/< | 1 - modifier may bypass | Check pair |
11043 | Dbrdmt musc&/fsca 1st 20/< | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 1 - modifier may bypass | Check pair |
11102 | Tangntl bx skin single les | 1 - modifier may bypass | Check pair |
11103 | Tangntl bx skin ea sep/addl | 1 - modifier may bypass | Check pair |
11104 | Punch bx skin single lesion | 1 - modifier may bypass | Check pair |
11105 | Punch bx skin ea sep/addl | 1 - modifier may bypass | Check pair |
11106 | Incal bx skn single les | 1 - modifier may bypass | Check pair |
11107 | Incal bx skn ea sep/addl | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check 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 code | Short description | Modifier indicator | |
|---|---|---|---|
0100T | Prosth retina receive&gen | 1 | Check pair |
0164T | Remove lumb artif disc addl | 1 | Check pair |
0165T | Revise lumb artif disc addl | 1 | Check pair |
0184T | Exc rectal tumor endoscopic | 1 | Check pair |
0200T | Perq sacral augmt unilat inj | 1 | Check pair |
0201T | Perq sacral augmt bilat inj | 1 | Check pair |
0202T | Post vert arthrplst 1 lumbar | 1 | Check pair |
0234T | Trluml perip athrc renal art | 1 | Check pair |
0235T | Trluml perip athrc visceral | 1 | Check pair |
0236T | Trluml perip athrc abd aorta | 1 | Check pair |
0237T | Trluml perip athrc brchiocph | 1 | Check pair |
0238T | Trluml perip athrc iliac art | 1 | Check pair |
0253T | Insert aqueous drain device | 1 | Check pair |
0308T | Insj ocular telescope prosth | 1 | Check pair |
0402T | Colgn crs-link crn&pachymtry | 1 | Check 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.