CPT code 11951: Filler injection, 1.1–5.0 cc2026 Medicare rate & RVUs in Vermont

Injection of 1.1 to 5.0 cc of subcutaneous filling material to correct a soft-tissue contour defect when Medicare coverage criteria are met.

CMS RVU26DEffective Oct 1, 2026One payment locality13 Medicare services in 2024

In Vermont, Medicare pays $113.06 for 11951 in the office and $58.50 when it’s performed in a hospital or facility.

$113.06Office (non-facility)
$58.50Hospital or facility
−3.6%vs the national office rate ($117.24)

Check a contract rate as a % of Medicare · 11951 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 11951 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 11951 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 11951 covers

This service is injection of filling material into subcutaneous tissue to improve a soft-tissue contour defect. Examples of materials include collagen-based fillers. Dermatologists and plastic surgeons may perform the procedure in a clinic or hospital setting, depending on the patient and treatment circumstances. Medicare payment is restricted to specific circumstances, so the clinical reason for treatment matters.

Select this code when the documented quantity injected falls from 1.1 through 5.0 cc; document the material, treatment site, amount, and reason for correction. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Vermont compares for 11951

Across 109 of 109 payment localities, the office rate for 11951 runs from $103.76 in Arkansas to $149.84 in San Benito County, CA. Vermont pays $113.06. The RVUs are the same everywhere; the geographic indexes change the dollars.

11951 in Vermont vs other payment areas
  1. Vermont · this page$113.06
  2. Los Angeles, CA · California$129.55+$16.49
  3. Washington, DC area · District of Columbia$132.85+$19.79
  4. Miami, FL · Florida$130.89+$17.83
  5. Chicago, IL · Illinois$126.95+$13.89
  6. Manhattan, NY · New York$135.41+$22.35
  7. Alaska · Alaska$138.11+$25.05

Other areas in Vermont first, then benchmark localities. Bars start at $0.

Every other payment area

11951 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$105.26$57.04
ArkansasArkansas$103.76$56.42
ArizonaArizona$114.01$60.61
Bakersfield, CACalifornia$122.09$61.69
Chico, CACalifornia$121.50$61.10
El Centro, CACalifornia$121.54$61.14
Fresno, CACalifornia$121.50$61.10
Hanford, CACalifornia$121.50$61.10

11951 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$103.76

$138.11

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
11951 office rate range by state
State / territoryOffice rate rangeLocalities
AK$138.111
AL$105.261
AR$103.761
AZ$114.011
CA$121.50–$149.8429
CO$120.741
CT$124.991
DC$132.851
DE$115.861
FL$117.62–$130.893
GA$110.86–$119.912
GU$124.081
HI$124.081
IA$106.931
ID$107.821
IL$114.97–$126.954
IN$108.411
KS$106.901
KY$108.711
LA$108.72–$113.972
MA$120.22–$131.922
MD$117.91–$132.853
ME$108.87–$114.012
MI$111.92–$119.552
MN$114.371
MO$107.19–$113.823
MS$105.471
MT$117.221
NC$109.921
ND$113.071
NE$107.371
NH$119.291
NJ$126.04–$131.592
NM$112.711
NV$116.141
NY$111.58–$139.245
OH$111.071
OK$108.021
OR$114.87–$124.002
PA$110.99–$122.222
PR$117.921
RI$119.571
SC$110.751
SD$112.581
TN$107.491
TX$110.31–$120.668
UT$112.231
VA$113.96–$132.852
VI$117.921
VT$113.061
WA$119.85–$134.122
WI$109.381
WV$110.901
WY$115.411

See 11951 in every payment locality

How the 11951 rate is calculated

Each of 11951’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 11951

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.16

1.16 RVUs× 1.000 GPCI

Practice expense2.14

2.14 RVUs× 1.000 GPCI

Malpractice0.21

0.21 RVUs× 1.000 GPCI

Adjusted RVUs

3.5100

Conversion factor

$33.4009

Medicare rate

$117.24

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Vermont inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,385

Code
11951
Physician work
1.16
Practice expense
2.14
Malpractice
0.21

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 11951 in Vermont
ComponentRVULocality factorAdjusted
Physician work1.16× 1.0001.1600
Practice expense2.14× 0.9902.1186
Malpractice0.21× 0.5060.1063
Total RVUs3.3849
Conversion factor× 33.4009

Office rate, Vermont$113.06

Office: (1.16 × 1 + 2.14 × 0.99 + 0.21 × 0.506) × $33.4009 = $113.06

Facility: (1.16 × 1 + 0.49 × 0.99 + 0.21 × 0.506) × $33.4009 = $58.50

Open 11951 in the RVU calculator

Payment rules and modifiers for 11951

The CMS indicators that decide how 11951 is paid alongside other services.

CMS payment indicators · 11951

Filler injection, 1.1–5.0 cc

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

11951 without 51 · national office

$117.24

Filler injection, 1.1–5.0 cc

11951-51 · Second procedure: 50%

$58.62

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 11951 has changed in Vermont

11951 · Office / nonfacility

$113.06

Effective 2026-10-01

The base rate is $10.02 higher than on 2025-10-01, moving from $103.04 to $113.06 (9.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $103.04changed to$113.06

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.19 changed to 1.16
    • Practice expense RVU 1.90 changed to 2.14
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $104.89changed to$103.04

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.86 changed to 1.90
    • Malpractice RVU 0.22 changed to 0.21

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $103.18changed to$104.89

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $106.20changed to$103.18

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.83 changed to 1.86
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $106.83changed to$106.20

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.77 changed to 1.83
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $106.47changed to$106.83

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.74 changed to 1.77
    • Malpractice RVU 0.21 changed to 0.22

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $107.96changed to$106.47

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.66 changed to 1.74
    • Malpractice RVU 0.22 changed to 0.21
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $98.90changed to$107.96

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.42 changed to 1.66
    • Malpractice RVU 0.19 changed to 0.22
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $101.87changed to$98.90

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.51 changed to 1.42
    • Malpractice RVU 0.18 changed to 0.19

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $99.85changed to$101.87

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.45 changed to 1.51
    • Malpractice RVU 0.20 changed to 0.18
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $96.62changed to$99.85

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.36 changed to 1.45
    • Malpractice RVU 0.21 changed to 0.20
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $105.99changed to$96.62

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.61 changed to 1.36

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $105.46changed to$105.99

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $101.78changed to$105.46

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.50 changed to 1.61
    • Malpractice RVU 0.23 changed to 0.21
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$101.78

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$113.06$58.50RVU26D
2026-07-01$113.06$58.50RVU26C
2026-04-01$113.06$58.50RVU26B
2026-01-01$113.06$58.50RVU26A
2025-10-01$103.04$67.06RVU25D
2025-07-01$103.04$67.06RVU25C
2025-04-01$103.04$67.06RVU25B
2025-01-01$103.04$67.06RVU25A
2024-10-01$104.89$68.53RVU24D
2024-07-01$104.89$68.53RVU24C
2024-04-01$104.89$68.53RVU24B
2024-03-09$104.89$68.53RVU24AR
2024-01-01$103.18$67.41RVU24A
2023-10-01$106.20$70.05RVU23D
2023-07-01$106.20$70.05RVU23C
2023-04-01$106.20$70.05RVU23B
2023-01-01$106.20$70.05RVU23A
2022-10-01$106.83$71.15RVU22D
2022-07-01$106.83$71.15RVU22C
2022-04-01$106.83$71.15RVU22B
2022-01-01$106.83$71.15RVU22A
2021-10-01$106.47$71.54RVU21D
2021-07-01$106.47$71.54RVU21C
2021-04-01$106.47$71.54RVU21B
2021-01-01$106.47$71.54RVU21A
2020-10-01$107.96$74.49RVU20D
2020-07-01$107.96$74.49RVU20C
2020-04-01$107.96$74.49RVU20B
2020-01-01$107.96$74.49RVU20A
2019-10-01$98.90$68.91RVU19D
2019-07-01$98.90$68.91RVU19C
2019-04-01$98.90$68.91RVU19B
2019-01-01$98.90$68.91RVU19A
2018-10-01$101.87$71.91RVU18D
2018-07-01$101.87$71.91RVU18C
2018-04-01$101.87$71.91RVU18B
2018-01-01$101.87$71.91RVU18AR1
2017-10-01$99.85$72.67RVU17D
2017-07-01$99.85$72.67RVU17C
2017-04-01$99.85$72.67RVU17B
2017-01-01$99.85$72.67RVU17A
2016-10-01$96.62$71.46RVU16D
2016-07-01$96.62$71.46RVU16C
2016-04-01$96.62$71.46RVU16B
2016-01-01$96.62$71.46RVU16A
2015-10-01$105.99$74.97RVU15D
2015-07-01$105.99$74.97RVU15C
2015-04-01$105.46$74.59RVU15B
2015-01-01$105.46$74.59RVU15A
2014-10-01$101.78$75.11RVU14D
2014-07-01$101.78$75.11RVU14C
2014-04-01$101.78$75.11RVU14B
2014-01-01$101.78$75.11RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 11951 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

11951 billing questions

How is this code distinguished from 11950 or 11952?

Choose by the volume of filling material injected: this code covers 1.1–5.0 cc, 11950 covers up to 1 cc, and 11952 covers 5.1–10 cc.

What documentation supports reporting this service?

Record the clinical reason for correcting the contour defect, the treatment site, the filling material, and the volume injected. Medicare payment is limited to specific circumstances.

Is same-day preoperative or postoperative care separately billable?

The 0-day global period includes same-day preoperative and postoperative care for this procedure.

Should modifier 50 be used for treatment on both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 11951PPRRVU2026_Oct_nonQPP.csv, line 1,385 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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