Injection of medication directly into skin lesions, covering up to and including seven lesions at one session.
- Medicare
- $56.78
- Work RVU
- 0.51
- Global, days
- 0
- Region
- Multi-region
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Number and location of lesions injected
- Drug, dose, and volume per lesion
- Lot number and wastage for single-dose vials
- Diagnosis such as keloid or hypertrophic scar
- Relationship to any recent surgery
- Response to prior injections
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
11900 covers intralesional injection of up to seven skin lesions in one session. 11901 is for more than seven. Common examples are steroid injection into a keloid, hypertrophic scar, or inflamed skin lesion.
In ortho, this code shows up when a surgeon injects a painful hypertrophic or keloid scar after surgery, often with triamcinolone. It does not cover joint, tendon sheath, ganglion, or trigger point injections, which have their own musculoskeletal codes. Scar injections in the global period of the original surgery may be considered part of postop care by some payers.
Bill the drug separately with its HCPCS code and units (for example, triamcinolone acetonide by the 10 mg unit). Medicare's drug wastage rules mean single-dose vials need the JW or JZ modifier. 11900 is billed once per session no matter the count up to seven. If an E/M is done on the same day, it needs 25 and a separate problem.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.51) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (1.7) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.51 |
| Practice expense RVU | 1.14 |
| Malpractice RVU | 0.05 |
| Total RVU | 1.7 |
| Medicare national rate | $56.78 |
| Global period | 0 days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $56.78 |
HOPD (APC 5051) Hospital outpatient department | $204.98 |
Common denial reasons
The recurring reasons claims for CPT 11900 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Used for joint, tendon, or trigger point injection
- Drug not billed or wrong units
- Missing JW or JZ on single-dose vial drug
- Scar injection inside the surgeon's global, treated by the payer as postop care
- Cosmetic indication without medical necessity
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can I use 11900 for a ganglion cyst injection?
02How many units of 11900?
03Is the steroid billed separately?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records the lesions injected, the drug and dose, and the reason, which is what the claim and drug line both need.
See how Mira captures CPT 11900 documentation