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CPT 11960 — Insert tissue expander(s)

CPT code 11960 (Insert tissue expander(s)) carries 11.2 work RVUs under the CMS 2026 Medicare Physician Fee Schedule. Total RVUs are 28.39 in a non-facility setting and 28.39 in a facility setting, which at the 2026 conversion factor of $33.40 works out to $948.25 and $948.25 respectively.

11.2
Work RVU
28.39
Total RVU (non-facility)
$948.25
Medicare, non-facility
$948.25
Medicare, facility
Calculate your total wRVUs →

RVU breakdown for CPT 11960

ComponentRVUsWhat it covers
Work RVU11.2Physician time, skill, effort, and stress.
Practice expense RVU (non-facility)15.21Office overhead, staff, supplies.
Practice expense RVU (facility)0.0Overhead when performed in a hospital.
Malpractice RVU1.98Professional liability cost.
Total RVU (non-facility)28.39Work + non-facility PE + malpractice.
Total RVU (facility)28.39Work + facility PE + malpractice.

How Medicare payment is calculated

Medicare multiplies total RVUs by the annual conversion factor. For CPT 11960 in 2026:

SettingTotal RVUConversion factorNational payment
Non-facility28.39$33.40$948.25
Facility28.39$33.40$948.25

These are national amounts. Actual payment is adjusted by the Geographic Practice Cost Index for your locality — check yours with the GPCI lookup.

Billing rules for CPT 11960

Global period
90-day global — major surgery; 90 days of follow-up care included.
Multiple procedure reduction
Subject to the standard multiple-procedure reduction (100%/50%/50%…).
Bilateral surgery
Bilateral adjustment does not apply.
Assistant surgeon
Not permitted.
Co-surgeon
Not permitted unless documentation supports medical necessity.
Team surgery
Not permitted unless documentation supports medical necessity.

Related codes

Codes in the same CMS family, with their work RVU values.

11970 · 7.3 wRVU

Questions about CPT 11960

How many work RVUs is CPT 11960?

CPT 11960 is assigned 11.2 work RVUs in the CMS 2026 Medicare Physician Fee Schedule.

What does Medicare pay for CPT 11960?

At the 2026 national conversion factor of $33.40, CPT 11960 pays approximately $948.25 in a non-facility setting and $948.25 in a facility setting before geographic adjustment.

What is the global period for CPT 11960?

90-day global — major surgery; 90 days of follow-up care included.

RVU values reflect the CMS 2026 Medicare Physician Fee Schedule (conversion factor $33.40). Payment figures are national and unadjusted for geography. Verify against the official fee schedule before using for billing.