11470 Exc skn h/p/p/u smpl/ntrm
What 11470 is
CMS fee schedule short descriptor: Exc skn h/p/p/u smpl/ntrm.
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 11470 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 3.65 | 10.57 | 0.79 | 15.01 | $501.35 |
| Facility (hospital, ASC) | 3.65 | 3.97 | 0.79 | 8.41 | $280.90 |
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: 90-day global period.
Medically Unlikely Edit (MUE)
Medicare caps 11470 at 3 units 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 11470? These codes are bundled into it
11470 is a Column 1 code in 210 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 |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0700T | Molec fluor img sus nev 1st | 1 - modifier may bypass | Check pair |
0701T | Molec fluor img sus nev ea | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 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 |
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11001 | Dbrdmt ecz/infct skn ea addl | 1 - modifier may bypass | Check pair |
11004 | Dbrdmt skin xtrnl gent&per | 1 - modifier may bypass | Check pair |
11005 | Dbrdmt skin abdominal wall | 1 - modifier may bypass | Check pair |
11006 | Dbrdmt skin xtrnl gent per | 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 |
11045 | Dbrdmt subq tiss each addl | 1 - modifier may bypass | Check pair |
11046 | Dbrdmt musc&/fsca ea addl | 1 - modifier may bypass | Check pair |
11047 | Dbrdmt bone each addl | 1 - modifier may bypass | Check pair |
11102 | Tangntl bx skin single les | 1 - modifier may bypass | Check pair |
11104 | Punch bx skin single lesion | 1 - modifier may bypass | Check pair |
11106 | Incal bx skn single les | 1 - modifier may bypass | Check pair |
11900 | Inject skin lesions </w 7 | 1 - modifier may bypass | Check pair |
11901 | Inject skin lesions >7 | 1 - modifier may bypass | Check pair |
12020 | Tx supfc wnd dehsn smpl clsr | 1 - modifier may bypass | Check pair |
12021 | Tx supfc wnd dehsn w/packing | 1 - modifier may bypass | Check pair |
15002 | Wound prep trk/arm/leg | 1 - modifier may bypass | Check pair |
Showing 30 of 210 column 2 codes. Use the pair checker for any specific combination.
11470 is bundled into these codes
11470 appears as a Column 2 code in 25 active edits. Reported with one of these Column 1 codes on the same date of service, 11470 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
10030 | Img gid flu coll drg sft tis | 1 | Check pair |
10060 | I&d abscess simple/single | 1 | Check pair |
10061 | I&d abscess comp/multiple | 1 | Check pair |
11010 | Debride skin at fx site | 1 | Check pair |
11011 | Debride skin musc at fx site | 1 | Check pair |
11012 | Deb skin bone at fx site | 1 | Check pair |
11200 | Rmvl skin tags up to&inc 15 | 1 | Check pair |
14000 | Tis trnfr trunk 10 sq cm/< | 1 | Check pair |
14001 | Tis trnfr trunk 10.1-30sqcm | 1 | Check pair |
14020 | Tis trnfr s/a/l 10 sq cm/< | 1 | Check pair |
14021 | Tis trnfr s/a/l 10.1-30 sqcm | 1 | Check pair |
14040 | Tis trnfr f/c/c/m/n/a/g/h/f | 1 | Check pair |
14041 | Tis trnfr f/c/c/m/n/a/g/h/f | 1 | Check pair |
14060 | Tis trnfr e/n/e/l 10 sq cm/< | 1 | Check pair |
14061 | Tis trnfr e/n/e/l10.1-30sqcm | 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.