CPT CODEAnesthesiaStatus A

CPT Code 11106Complete Billing & Coding Guide (2026)Incal bx skn single les

Reviewed by AAPC-Certified Coders2026 Medicare Fee ScheduleCMS + AMA Sources
Medicare Payment
$151
Non-facility · National avg
Facility
$46
Total RVU
4.53
Global
000
Payment
$151
non-facility
Work RVU
0.98
physician effort
Global Period
000
post-op days
Bundling Edits
10
NCCI pairs

About CPT 11106

CPT 11106 is a Current Procedural Terminology code in the Anesthesia category maintained by the American Medical Association. The CMS short descriptor reads "Incal bx skn single les". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

Documentation specificity, correct ICD-10 linkage, and modifier accuracy determine whether 11106 pays cleanly or triggers a denial. Verify CMS National Physician Fee Schedule status, applicable Medicare LCDs, and any payer-specific medical policies before submission.

Pro Tip

11106 has 10 NCCI bundling edit pairs documented. Run your scrubber against the NCCI quarterly update before submission. When clinically warranted, use modifier 59 or the X-modifiers (XE, XS, XP, XU) to bypass an indicator-1 edit, with chart documentation supporting the distinct service.

Code Properties

Global Period
000
0-day global period (no postoperative days)
Status Indicator
A
Active. Payment under Medicare PFS.
Conversion Factor
$33.4009
CMS national rate
Effective Date
2026-04-01
per CMS publication

RVU Breakdown

Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.

RVU Composition
4.53 total RVU
0.98
3.43
Work RVU
0.98 · 22%
Physician time + skill
Practice Expense
3.43 · 76%
Office & equipment
Malpractice
0.12 · 3%
Liability insurance
Non-Facility
Private office · urgent care · ambulatory
Most billed
$151.31
4.53 RVU × $33.4009 CF
Facility
Hospital · ASC · nursing home
$46.43
1.39 RVU × $33.4009 CF

Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.

Medicare Payment by State

Medicare adjusts payment by locality based on GPCI (Geographic Practice Cost Index). Higher cost-of-living areas like California and New York pay more. Rural states pay less. Top 12 states shown.

DC
$174
AK
$173
CA
$172
NJ
$168
NY
$168
WA
$168
MA
$166
HI
$165
CT
$162
CO
$158
MD
$157
OR
$157

Showing top 12 of 53 states. Full locality data available in CMS PFS Locality file.

NCCI Bundling Edits

10 pairs

These codes trigger National Correct Coding Initiative edits when billed with 11106. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.

Common Denial Risk

Billing 11106 alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.

AR Recovery Note

Bundling denials on 11106 are recoverable when the edit indicator is 1 and the chart documents a distinct, separately identifiable service. Our coders verify the indicator and pick the precise X-modifier (XE, XS, XP, XU) instead of defaulting to modifier 59.

Applicable Modifiers

Modifiers commonly paired with 11106 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.

33
Preventive services — when the primary purpose is delivery of an evidence-based service per USPSTF A or B recommendation
When to use · Screening services (colonoscopy, mammography, etc.) to indicate the primary purpose is preventive. Waives cost-sharing under ACA.
AA
Anesthesia services performed personally by anesthesiologist
When to use · Anesthesiologist personally performed the entire anesthesia service.
GA
Waiver of liability statement issued as required by payer policy (ABN on file)
When to use · Medicare: when an Advance Beneficiary Notice (ABN) has been signed by the patient for services that may not be covered.
GY
Item or service statutorily excluded or does not meet the definition of any Medicare benefit
When to use · Service is never covered by Medicare (e.g., cosmetic procedures). May bill patient directly.
GZ
Item or service expected to be denied as not reasonable and necessary — no ABN on file
When to use · When a service is expected to be denied by Medicare and no ABN was obtained. Provider cannot bill the patient.
KX
Requirements specified in the medical policy have been met
When to use · Attestation that LCD/NCD criteria have been met. Common with therapy cap exceptions and DME.
P1
Normal healthy patient — ASA physical status 1
When to use · A normal healthy patient
P2
Patient with mild systemic disease — ASA physical status 2
When to use · A patient with mild systemic disease
AR Recovery Note

Modifier audits catch what scrubbers miss. Our AAPC-certified team reviews every modifier choice on 11106 against the chart documentation before submission, surfacing missed and misapplied modifiers across the practice.

Supporting ICD-10 Diagnoses

These diagnosis codes commonly support medical necessity for CPT 11106. Using the correct ICD-10 prevents CARC 50 denials. Payer rejects when the diagnosis doesn’t support the procedure.

1
Incisional biopsy skin — uncertain neoplasm, skin cancer, melanoma, nevi, actinic keratosis, BCC/SCC by site
Dermatology
D48.5See ICD-10-CM tabular index
C44.91See ICD-10-CM tabular index
C43.9See ICD-10-CM tabular index
D22.9See ICD-10-CM tabular index
L57.0See ICD-10-CM tabular index
L98.9See ICD-10-CM tabular index
C44.01See ICD-10-CM tabular index
C44.11See ICD-10-CM tabular index
C44.21See ICD-10-CM tabular index
C44.31See ICD-10-CM tabular index
AR Recovery Note

CARC 50 medical-necessity denials carry both rework cost and an audit-risk signal when patterns repeat. Our coders verify ICD-10 specificity and policy alignment at the coding stage so these losses get prevented upstream.

Free 90-Day AR Recovery Audit

Find the revenue leakage in your 11106 claims.

Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Anesthesia claims. Our AAPC-certified team audits your last 90 days of 11106 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.

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FAQ

Everything about CPT 11106

What does CPT code 11106 cover?

CPT 11106 is a Current Procedural Terminology code in the Anesthesia category maintained by the American Medical Association. The CMS short descriptor reads "Incal bx skn single les". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

What is the Medicare payment for CPT 11106?

The national average Medicare payment for CPT 11106 is approximately $151.31 in a non-facility setting and $46.43 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 4.53 with a conversion factor of $33.4009.

What is the global period for CPT 11106?

CPT 11106 has a 0-day global period (indicator 000). Same-day E/M is bundled into the procedure, but office visits the next day or after are separately billable for unrelated care. Use modifier 24 for unrelated E/M during the global period.

What codes bundle with CPT 11106?

CPT 11106 has NCCI Procedure-to-Procedure edits with 10+ codes including 00170, 0213T, 0216T. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.

CMS Medicare Physician Fee ScheduleNCCI Edits · Current QuarterAMA CPT Code Set

CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.

Free 90-Day AR Recovery Audit

We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.