CPT code 11954: Filler injection, more than 10 cc2026 Medicare rate & RVUs in Tennessee

Reports subcutaneous injection of filling material when the documented volume exceeds 10 cc to address a soft-tissue volume or contour defect.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Tennessee, Medicare pays $158.70 for 11954 in the office and $88.56 when it’s performed in a hospital or facility.

$158.70Office (non-facility)
$88.56Hospital or facility
−8.5%vs the national office rate ($173.35)

Check a contract rate as a % of Medicare · 11954 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 11954 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Tennessee
  2. What 11954 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 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.

How Tennessee compares for 11954

Across 109 of 109 payment localities, the office rate for 11954 runs from $153.36 in Arkansas to $219.42 in San Benito County, CA. Tennessee pays $158.70. The RVUs are the same everywhere; the geographic indexes change the dollars.

11954 in Tennessee vs other payment areas
  1. Tennessee · this page$158.70
  2. Los Angeles, CA · California$190.47+$31.77
  3. Washington, DC area · District of Columbia$195.99+$37.29
  4. Miami, FL · Florida$195.39+$36.69
  5. Chicago, IL · Illinois$189.42+$30.72
  6. Manhattan, NY · New York$200.50+$41.80
  7. Alaska · Alaska$204.76+$46.06

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

Every other payment area

11954 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$155.58$88.07
ArkansasArkansas$153.36$87.09
ArizonaArizona$168.52$93.76
Bakersfield, CACalifornia$179.67$95.11
Chico, CACalifornia$178.70$94.13
El Centro, CACalifornia$178.75$94.19
Fresno, CACalifornia$178.70$94.13
Hanford, CACalifornia$178.70$94.13

11954 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.

$153.36

$204.76

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

View every state and territory as a table
11954 office rate range by state
State / territoryOffice rate rangeLocalities
AK$204.761
AL$155.581
AR$153.361
AZ$168.521
CA$178.70–$219.4229
CO$178.011
CT$184.831
DC$195.991
DE$171.251
FL$174.76–$195.393
GA$164.63–$177.512
GU$182.341
HI$182.341
IA$157.671
ID$159.071
IL$171.10–$189.424
IN$159.931
KS$157.801
KY$161.091
LA$161.18–$168.952
MA$177.32–$194.232
MD$174.21–$195.993
ME$160.81–$168.122
MI$166.02–$177.822
MN$168.071
MO$159.03–$168.503
MS$156.191
MT$173.331
NC$162.331
ND$166.411
NE$158.261
NH$176.051
NJ$186.23–$194.182
NM$167.271
NV$171.501
NY$164.80–$206.415
OH$164.611
OK$159.881
OR$169.47–$182.592
PA$164.38–$180.852
PR$174.291
RI$176.581
SC$163.881
SD$165.591
TN$158.701
TX$163.38–$178.038
UT$166.071
VA$168.19–$195.992
VI$174.291
VT$166.561
WA$176.72–$197.272
WI$161.001
WV$165.091
WY$170.311

See 11954 in every payment locality

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

Office or facility?

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.

The exact Tennessee inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,387

Code
11954
Physician work
1.80
Practice expense
3.04
Malpractice
0.35

GPCI2026.csv

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Office calculation for 11954 in Tennessee
ComponentRVULocality factorAdjusted
Physician work1.80× 1.0001.8000
Practice expense3.04× 0.9092.7634
Malpractice0.35× 0.5370.1880
Total RVUs4.7513
Conversion factor× 33.4009

Office rate, Tennessee$158.70

Office: (1.8 × 1 + 3.04 × 0.909 + 0.35 × 0.537) × $33.4009 = $158.70

Facility: (1.8 × 1 + 0.73 × 0.909 + 0.35 × 0.537) × $33.4009 = $88.56

Open 11954 in the RVU calculator

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

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

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%).

When to use modifier 51

How 11954 has changed in Tennessee

11954 · Office / nonfacility

$158.70

Effective 2026-10-01

The base rate is $15.20 higher than on 2025-10-01, moving from $143.50 to $158.70 (10.6%).

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

    $143.50changed to$158.70

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.85 changed to 1.80
    • Practice expense RVU 2.68 changed to 3.04
    • Malpractice RVU 0.34 changed to 0.35
    • Practice expense GPCI 0.896 changed to 0.909
    • Malpractice GPCI 0.544 changed to 0.537

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $145.88changed to$143.50

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.62 changed to 2.68

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $143.50changed to$145.88

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $146.82changed to$143.50

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.58 changed to 2.62
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.518 changed to 0.544
  5. January 1, 2023

    RVU23A

    $146.67changed to$146.82

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.49 changed to 2.58
    • Practice expense GPCI 0.892 changed to 0.894
    • Malpractice GPCI 0.492 changed to 0.518

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $146.47changed to$146.67

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.45 changed to 2.49
    • Malpractice RVU 0.33 changed to 0.34

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $149.37changed to$146.47

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.37 changed to 2.45
    • Malpractice RVU 0.32 changed to 0.33
    • Practice expense GPCI 0.897 changed to 0.892
    • Malpractice GPCI 0.509 changed to 0.492

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $145.80changed to$149.37

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.25 changed to 2.37
    • Practice expense GPCI 0.901 changed to 0.897
    • Malpractice GPCI 0.526 changed to 0.509

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $145.61changed to$145.80

    • Malpractice RVU 0.31 changed to 0.32

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $146.75changed to$145.61

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.29 changed to 2.25

    Held through RVU19B.

  11. April 1, 2018

    RVU18B

    No ratechanged to$146.75

    Held through RVU18C, RVU18D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$158.70$88.56RVU26D
2026-07-01$158.70$88.56RVU26C
2026-04-01$158.70$88.56RVU26B
2026-01-01$158.70$88.56RVU26A
2025-10-01$143.50$100.02RVU25D
2025-07-01$143.50$100.02RVU25C
2025-04-01$143.50$100.02RVU25B
2025-01-01$143.50$100.02RVU25A
2024-10-01$145.88$101.74RVU24D
2024-07-01$145.88$101.74RVU24C
2024-04-01$145.88$101.74RVU24B
2024-03-09$145.88$101.74RVU24AR
2024-01-01$143.50$100.08RVU24A
2023-10-01$146.82$103.20RVU23D
2023-07-01$146.82$103.20RVU23C
2023-04-01$146.82$103.20RVU23B
2023-01-01$146.82$103.20RVU23A
2022-10-01$146.67$104.38RVU22D
2022-07-01$146.67$104.38RVU22C
2022-04-01$146.67$104.38RVU22B
2022-01-01$146.67$104.38RVU22A
2021-10-01$146.47$105.39RVU21D
2021-07-01$146.47$105.39RVU21C
2021-04-01$146.47$105.39RVU21B
2021-01-01$146.47$105.39RVU21A
2020-10-01$149.37$108.90RVU20D
2020-07-01$149.37$108.90RVU20C
2020-04-01$149.37$108.90RVU20B
2020-01-01$149.37$108.90RVU20A
2019-10-01$145.80$106.83RVU19D
2019-07-01$145.80$106.83RVU19C
2019-04-01$145.61$106.64RVU19B
2019-01-01$145.61$106.64RVU19A
2018-10-01$146.75$107.82RVU18D
2018-07-01$146.75$107.82RVU18C
2018-04-01$146.75$107.82RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
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 11954 for an earlier date of service

Where the Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

  • Adams
  • Adamsville
  • Alamo
  • Alcoa
  • Alexandria
  • Algood
  • Allardt
  • Altamont

Browse all communities in Tennessee

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

Show the CMS file lines behind this rate
RVUs for 11954PPRRVU2026_Oct_nonQPP.csv, line 1,387 (RVU26D)
Geographic factors for TennesseeGPCI2026.csv, line 95 (RVU26D)

Open CMS sourceHow we calculate rates

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