CPT CODEAnesthesiaStatus A

CPT Code 11008Complete Billing & Coding Guide (2026)Rmv prstc mtrl/mesh abd wall

Reviewed by AAPC-Certified Coders2026 Medicare Fee ScheduleCMS + AMA Sources
Medicare Payment
$244
Non-facility · National avg
Facility
$244
Total RVU
7.32
Global
ZZZ
Payment
$244
non-facility
Work RVU
4.88
physician effort
Global Period
ZZZ
post-op days
Bundling Edits
3
NCCI pairs

About CPT 11008

CPT 11008 is a Current Procedural Terminology code in the Anesthesia category maintained by the American Medical Association. The CMS short descriptor reads "Rmv prstc mtrl/mesh abd wall". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

Add-on codes cannot be billed alone and inherit their global period from the primary procedure. Payer scrubbers will reject add-on codes submitted without a valid base code on the same claim.

Pro Tip

11008 has 3 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
ZZZ
Add-on code (global period matches base procedure)
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
7.32 total RVU
4.88
1.19
1.25
Work RVU
4.88 · 67%
Physician time + skill
Practice Expense
1.19 · 16%
Office & equipment
Malpractice
1.25 · 17%
Liability insurance
Non-Facility
Private office · urgent care · ambulatory
Most billed
$244.49
7.32 RVU × $33.4009 CF
Facility
Hospital · ASC · nursing home
$244.49
7.32 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.

AK
$310
FL
$284
IL
$282
NY
$272
DC
$265
NJ
$261
CT
$260
MI
$259
WV
$257
MD
$252
GA
$251
NM
$250

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

NCCI Bundling Edits

3 pairs

These codes trigger National Correct Coding Initiative edits when billed with 11008. 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 11008 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 11008 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 11008 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 11008 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 11008. Using the correct ICD-10 prevents CARC 50 denials. Payer rejects when the diagnosis doesn’t support the procedure.

1
CMS LCD: Billing and Coding: Wound and Ulcer Care
CMS LCD
E10.620See ICD-10-CM tabular index
E10.621See ICD-10-CM tabular index
E10.622See ICD-10-CM tabular index
E10.628See ICD-10-CM tabular index
E10.65See ICD-10-CM tabular index
E10.69See ICD-10-CM tabular index
E11.620See ICD-10-CM tabular index
E11.621See ICD-10-CM tabular index
E11.622See ICD-10-CM tabular index
E11.628See ICD-10-CM tabular index
E11.65Type 2 diabetes mellitus with hyperglycemia
E11.69See 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 11008 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 11008 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.

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FAQ

Everything about CPT 11008

What does CPT code 11008 cover?

CPT 11008 is a Current Procedural Terminology code in the Anesthesia category maintained by the American Medical Association. The CMS short descriptor reads "Rmv prstc mtrl/mesh abd wall". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

What is the Medicare payment for CPT 11008?

The national average Medicare payment for CPT 11008 is approximately $244.49 in a non-facility setting and $244.49 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 7.32 with a conversion factor of $33.4009.

What is the global period for CPT 11008?

CPT 11008 is an add-on code (indicator ZZZ). Its global period matches the base procedure it's billed with. Cannot be billed alone. Must be paired with a primary code per CPT guidelines.

What codes bundle with CPT 11008?

CPT 11008 has NCCI Procedure-to-Procedure edits with 3+ codes including 36591, 36592, 96523. 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.