No office rate
Use 19357 for breast reconstruction with a tissue expander; it includes subsequent expansion. Code 11960 describes expander insertion in other reconstructive contexts.
On this page
CMS RVU26D · Effective 2026-10-01
11960 in El Centro
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$973.03
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Reconstructive surgery
About 11960: Subcutaneous tissue expander insertion
Report tissue expander insertion when a surgeon places an expandable device beneath the skin to develop tissue for later reconstruction or coverage.
A plastic or reconstructive surgeon places one or more expandable devices beneath the skin near an area that needs additional tissue. Expansion can prepare skin for reconstruction or coverage after problems such as burns, trauma, or removal of a lesion. Tissue expansion is used at sites including the scalp and extremities; breast reconstruction has its own specific code. Placement may occur in a hospital or another surgical setting.
Report this service for the expander placement itself, supported by the operative note describing the site, device placement, and reconstructive purpose. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 11960
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.20 · 39%
- Practice expense (office) RVU15.21 · 54%
- Malpractice RVU1.98 · 7%
218
Medicare services in 2024 · #4250 by national volume
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.
11960 compared with similar codes
Office rates for El Centro, from the same CMS release.
No office rate
11970 describes replacing an existing tissue expander with a permanent prosthesis, not placing the expander.
No office rate
11971 describes removing a tissue expander without inserting a permanent prosthesis; it is not the initial placement service.
The same code, a different location
How does El Centro compare?
11960 across payment areas
Same release and payment basis · bars start at $0
El Centro · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 11960
Office
Unavailable
Facility
$972.70
No comparable office rate is available.
Modesto
California · 11960
Office
Unavailable
Facility
$972.70
No comparable office rate is available.
Napa
California · 11960
Office
Unavailable
Facility
$1100.83
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 11960
Office
Unavailable
Facility
$1026.25
No comparable office rate is available.
Redding
California · 11960
Office
Unavailable
Facility
$972.70
No comparable office rate is available.
Rest Of California
California · 11960
Office
Unavailable
Facility
$972.70
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 11960
Office
Unavailable
Facility
$994.03
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 11960
Office
Unavailable
Facility
$1013.84
No comparable office rate is available.
Salinas
California · 11960
Office
Unavailable
Facility
$1009.94
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 11960
Office
Unavailable
Facility
$1028.76
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 11960
Office
Unavailable
Facility
$1156.30
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 11960
Office
Unavailable
Facility
$1154.05
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 11960
Office
Unavailable
Facility
$1183.26
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 11960
Office
Unavailable
Facility
$1174.07
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 11960
Office
Unavailable
Facility
$994.54
No comparable office rate is available.
Santa Cruz-Watsonville
California · 11960
Office
Unavailable
Facility
$1034.65
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 11960
Office
Unavailable
Facility
$1012.37
No comparable office rate is available.
Santa Rosa-Petaluma
California · 11960
Office
Unavailable
Facility
$1044.62
No comparable office rate is available.
Stockton
California · 11960
Office
Unavailable
Facility
$972.70
No comparable office rate is available.
Vallejo
California · 11960
Office
Unavailable
Facility
$1097.59
No comparable office rate is available.
Visalia
California · 11960
Office
Unavailable
Facility
$972.70
No comparable office rate is available.
Yuba City
California · 11960
Office
Unavailable
Facility
$972.70
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 11960
Office
Unavailable
Facility
$1066.35
No comparable office rate is available.
Miami
Florida · 11960
Office
Unavailable
Facility
$1070.20
No comparable office rate is available.
Chicago
Illinois · 11960
Office
Unavailable
Facility
$1039.05
No comparable office rate is available.
Manhattan
New York · 11960
Office
Unavailable
Facility
$1093.25
No comparable office rate is available.
Alaska*
Alaska · 11960
Office
Unavailable
Facility
$1138.62
No comparable office rate is available.
Alabama
Alabama · 11960
Office
Unavailable
Facility
$856.05
No comparable office rate is available.
Arkansas
Arkansas · 11960
Office
Unavailable
Facility
$844.54
No comparable office rate is available.
Arizona
Arizona · 11960
Office
Unavailable
Facility
$922.98
No comparable office rate is available.
Colorado
Colorado · 11960
Office
Unavailable
Facility
$970.77
No comparable office rate is available.
Connecticut
Connecticut · 11960
Office
Unavailable
Facility
$1008.74
No comparable office rate is available.
Delaware
Delaware · 11960
Office
Unavailable
Facility
$937.35
No comparable office rate is available.
Fort Lauderdale
Florida · 11960
Office
Unavailable
Facility
$1008.29
No comparable office rate is available.
Rest Of Florida
Florida · 11960
Office
Unavailable
Facility
$959.16
No comparable office rate is available.
Atlanta
Georgia · 11960
Office
Unavailable
Facility
$970.80
No comparable office rate is available.
Rest Of Georgia
Georgia · 11960
Office
Unavailable
Facility
$906.08
No comparable office rate is available.
Hawaii, Guam
Hawaii · 11960
Office
Unavailable
Facility
$990.01
No comparable office rate is available.
Iowa
Iowa · 11960
Office
Unavailable
Facility
$865.19
No comparable office rate is available.
Idaho
Idaho · 11960
Office
Unavailable
Facility
$872.76
No comparable office rate is available.
East St. Louis
Illinois · 11960
Office
Unavailable
Facility
$974.67
No comparable office rate is available.
Rest Of Illinois
Illinois · 11960
Office
Unavailable
Facility
$941.29
No comparable office rate is available.
Suburban Chicago
Illinois · 11960
Office
Unavailable
Facility
$1015.64
No comparable office rate is available.
Indiana
Indiana · 11960
Office
Unavailable
Facility
$877.17
No comparable office rate is available.
Kansas
Kansas · 11960
Office
Unavailable
Facility
$866.68
No comparable office rate is available.
Kentucky
Kentucky · 11960
Office
Unavailable
Facility
$886.24
No comparable office rate is available.
New Orleans
Louisiana · 11960
Office
Unavailable
Facility
$927.27
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 11960
Office
Unavailable
Facility
$887.05
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 11960
Office
Unavailable
Facility
$1054.87
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 11960
Office
Unavailable
Facility
$967.74
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 11960
Office
Unavailable
Facility
$1007.00
No comparable office rate is available.
Rest Of Maryland
Maryland · 11960
Office
Unavailable
Facility
$952.67
No comparable office rate is available.
Rest Of Maine
Maine · 11960
Office
Unavailable
Facility
$882.61
No comparable office rate is available.
Southern Maine
Maine · 11960
Office
Unavailable
Facility
$919.28
No comparable office rate is available.
Detroit
Michigan · 11960
Office
Unavailable
Facility
$975.84
No comparable office rate is available.
Rest Of Michigan
Michigan · 11960
Office
Unavailable
Facility
$912.58
No comparable office rate is available.
Minnesota
Minnesota · 11960
Office
Unavailable
Facility
$916.43
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 11960
Office
Unavailable
Facility
$915.74
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 11960
Office
Unavailable
Facility
$924.00
No comparable office rate is available.
Rest Of Missouri
Missouri · 11960
Office
Unavailable
Facility
$876.42
No comparable office rate is available.
Mississippi
Mississippi · 11960
Office
Unavailable
Facility
$860.37
No comparable office rate is available.
Montana**
Montana · 11960
Office
Unavailable
Facility
$948.12
No comparable office rate is available.
North Carolina
North Carolina · 11960
Office
Unavailable
Facility
$890.34
No comparable office rate is available.
North Dakota**
North Dakota · 11960
Office
Unavailable
Facility
$908.97
No comparable office rate is available.
Nebraska
Nebraska · 11960
Office
Unavailable
Facility
$868.00
No comparable office rate is available.
New Hampshire
New Hampshire · 11960
Office
Unavailable
Facility
$960.81
No comparable office rate is available.
Northern Nj
New Jersey · 11960
Office
Unavailable
Facility
$1057.60
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 11960
Office
Unavailable
Facility
$1016.37
No comparable office rate is available.
New Mexico
New Mexico · 11960
Office
Unavailable
Facility
$919.38
No comparable office rate is available.
Nevada**
Nevada · 11960
Office
Unavailable
Facility
$937.72
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 11960
Office
Unavailable
Facility
$1124.89
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 11960
Office
Unavailable
Facility
$1027.24
No comparable office rate is available.
Queens
New York · 11960
Office
Unavailable
Facility
$1093.89
No comparable office rate is available.
Rest Of New York
New York · 11960
Office
Unavailable
Facility
$903.21
No comparable office rate is available.
Ohio
Ohio · 11960
Office
Unavailable
Facility
$904.58
No comparable office rate is available.
Oklahoma
Oklahoma · 11960
Office
Unavailable
Facility
$879.14
No comparable office rate is available.
Portland
Oregon · 11960
Office
Unavailable
Facility
$993.70
No comparable office rate is available.
Rest Of Oregon
Oregon · 11960
Office
Unavailable
Facility
$926.58
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 11960
Office
Unavailable
Facility
$988.58
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 11960
Office
Unavailable
Facility
$902.96
No comparable office rate is available.
Puerto Rico
Puerto Rico · 11960
Office
Unavailable
Facility
$952.85
No comparable office rate is available.
Rhode Island
Rhode Island · 11960
Office
Unavailable
Facility
$964.98
No comparable office rate is available.
South Carolina
South Carolina · 11960
Office
Unavailable
Facility
$899.72
No comparable office rate is available.
South Dakota**
South Dakota · 11960
Office
Unavailable
Facility
$904.34
No comparable office rate is available.
Tennessee
Tennessee · 11960
Office
Unavailable
Facility
$871.40
No comparable office rate is available.
Austin
Texas · 11960
Office
Unavailable
Facility
$970.93
No comparable office rate is available.
Beaumont
Texas · 11960
Office
Unavailable
Facility
$897.83
No comparable office rate is available.
Brazoria
Texas · 11960
Office
Unavailable
Facility
$932.12
No comparable office rate is available.
Dallas
Texas · 11960
Office
Unavailable
Facility
$940.20
No comparable office rate is available.
Fort Worth
Texas · 11960
Office
Unavailable
Facility
$935.97
No comparable office rate is available.
Galveston
Texas · 11960
Office
Unavailable
Facility
$936.31
No comparable office rate is available.
Houston
Texas · 11960
Office
Unavailable
Facility
$972.55
No comparable office rate is available.
Rest Of Texas
Texas · 11960
Office
Unavailable
Facility
$915.93
No comparable office rate is available.
Utah
Utah · 11960
Office
Unavailable
Facility
$911.02
No comparable office rate is available.
Virginia
Virginia · 11960
Office
Unavailable
Facility
$920.17
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 11960
Office
Unavailable
Facility
$952.85
No comparable office rate is available.
Vermont
Vermont · 11960
Office
Unavailable
Facility
$910.50
No comparable office rate is available.
Rest Of Washington
Washington · 11960
Office
Unavailable
Facility
$964.23
No comparable office rate is available.
Seattle (King Cnty)
Washington · 11960
Office
Unavailable
Facility
$1070.18
No comparable office rate is available.
Wisconsin
Wisconsin · 11960
Office
Unavailable
Facility
$881.15
No comparable office rate is available.
West Virginia
West Virginia · 11960
Office
Unavailable
Facility
$910.20
No comparable office rate is available.
Wyoming**
Wyoming · 11960
Office
Unavailable
Facility
$931.06
No comparable office rate is available.
See how rates vary across the country
11960 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 11960 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1070.33
$973.03 × 110% = $1070.33
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 11960 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
1,388
- Code
- 11960
- Physician work
- 11.20
- Practice expense
- 15.21
- Malpractice
- 1.98
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.20 | × 1.017 | 11.3904 |
| Practice expense | 15.21 | × 1.096 | 16.6702 |
| Malpractice | 1.98 | × 0.541 | 1.0712 |
| Total RVUs | 29.1317 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, El Centro$973.03
Open 11960 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.2 | 1.017 |
| Practice expense | 15.21 | 1.096 |
| Malpractice | 1.98 | 0.541 |
(11.2 × 1.017 + 15.21 × 1.096 + 1.98 × 0.541) × $33.4009 = $973.03
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
11960 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $973.03 | RVU26D |
| 2026-07-01 | Not available in this setting | $973.03 | RVU26C |
| 2026-04-01 | Not available in this setting | $973.03 | RVU26B |
| 2026-01-01 | Not available in this setting | $973.03 | RVU26A |
| 2025-10-01 | Not available in this setting | $1031.02 | RVU25D |
| 2025-07-01 | Not available in this setting | $1031.02 | RVU25C |
| 2025-04-01 | Not available in this setting | $1031.02 | RVU25B |
| 2025-01-01 | Not available in this setting | $1031.02 | RVU25A |
11960 billing questions
How is this different from breast reconstruction with a tissue expander?
For breast reconstruction with an expander, compare 19357, the breast-specific reconstruction service that includes subsequent expansion. Select the code that matches the operative service and site.
Is the code reported once for each expander?
The descriptor covers one or more expanders. Do not assign units by counting devices.
Does the 90-day global period include related postoperative care?
Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used when expanders are placed on both sides?
No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,38511951,,Subq njx fil matrl 1.1-5.0cc,R,,1.16,2.14,,0.49,,0.21,3.51,1.86,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,38611952,,Subq njx fil matrl 5.1-10cc,R,,1.65,2.74,,0.67,,0.30,4.69,2.62,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,38711954,,Subq njx fil matrl>10.0 cc,R,,1.80,3.04,,0.73,,0.35,5.19,2.88,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,38811960,,Insert tissue expander(s),A,,11.20,15.21,NA,15.21,,1.98,28.39,28.39,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,38911970,,Rplcmt tiss xpndr perm implt,A,,7.30,6.84,NA,6.84,,1.35,15.49,15.49,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,39011971,,Rmvl tis xpndr wo insj implt,A,,6.84,7.32,NA,7.32,,1.28,15.44,15.44,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,39111976,,Remove contraceptive capsule,R,,1.74,2.35,,0.36,,0.30,4.39,2.40,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664