CPT code 11954: Filler injection, more than 10 cc2026 Medicare rate & RVUs in Missouri
Reports subcutaneous injection of filling material when the documented volume exceeds 10 cc to address a soft-tissue volume or contour defect.
Medicare pays $159.03–$168.50 for 11954 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 11954 covers
A clinician injects filling material into subcutaneous tissue to add volume or improve a soft-tissue contour defect. Dermatologists and plastic surgeons may perform the service in an office or procedural setting when more than 10 cc of material is used. The code is distinguished from its lower-volume siblings by the amount injected, not by the number of sites treated.
Select the code from documentation of the indication, injection sites, material, and total volume. Medicare payment is restricted to specific circumstances, so the record must support the applicable coverage circumstances. The code has a 0-day global period, which includes same-day preoperative and postoperative care. When multiple procedures are performed in the same 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.
Where 11954 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$159.03 to $168.50
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $166.89 | $94.44 |
| Metropolitan St. Louis, MO | $168.50 | $95.05 |
| Rest of Missouri | $159.03 | $92.53 |
How the 11954 rate is calculated
Each of 11954’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 · 11954
RVUs × geographic indexes × conversion factor
Work1.80
1.80 RVUs× 1.000 GPCI
Practice expense3.04
3.04 RVUs× 1.000 GPCI
Malpractice0.35
0.35 RVUs× 1.000 GPCI
Adjusted RVUs
5.1900
Conversion factor
$33.4009
Medicare rate
$173.35
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11954
The CMS indicators that decide how 11954 is paid alongside other services.
CMS payment indicators · 11954
Filler injection, more than 10 cc
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11954 without 51 · national office
$173.35
Filler injection, more than 10 cc
11954-51 · Second procedure: 50%
$86.68
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%).
11954 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 11950Filler injection1 cc or less
- Use 11950 for the smallest volume tier of subcutaneous filling material; use 11954 when the total volume exceeds 10 cc.
- 11951Filler injection1.1–5.0 cc
- 11951 covers an intermediate volume tier. 11954 is selected when more than 10 cc is injected.
- 11952Filler injection5.1 to 10 cc
- 11952 covers volumes through 10 cc; 11954 applies when the documented volume is greater than 10 cc.
11954 billing questions
How does 11954 differ from 11952?
Choose 11954 when the documented filling-material volume exceeds 10 cc. Code 11952 is for the next lower volume tier, up to 10 cc.
Is the code selected by the number of injection sites?
No. The distinction among these filling-material injection codes is the volume used, rather than the number of sites.
What documentation supports reporting 11954?
Document the clinical indication, injection sites, material, and total volume injected. The record must also support the specific circumstances for which Medicare covers payment.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
Can modifier 50 be used, or can an assistant be paid?
Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity.
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
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