Paring or trimming of two to four benign thickened skin lesions, such as corns or calluses, at one visit.
- Medicare
- $81.16
- Work RVU
- 0.49
- Global, days
- 0
- Region
- Foot & ankle
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Each lesion location, two to four in total
- Qualifying systemic diagnosis
- Class findings for the Q modifier
- Treating physician and last visit date, when required
- Paring method and symptoms addressed
- Frequency of past treatment
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
11056 covers paring of two, three, or four hyperkeratotic lesions in the same session. The count is the total across both feet and any other site. One lesion is 11055 and five or more is 11057.
This is a podiatry and foot and ankle code. Patients with diabetes, neuropathy, or vascular disease often have multiple calluses under the metatarsal heads and on the toes that need regular care. Medicare covers it only when routine foot care rules are met: a qualifying systemic condition, documented class findings, and the right Q modifier.
Denials come from counting errors and from missing qualifying information. Write the location of each lesion, not just "calluses x3." If you are tracking frequency, check the LCD that applies in your jurisdiction. Billing an E/M on the same day needs modifier 25 and a separate problem addressed. If the patient knows the service is not covered, use GA with a valid ABN or GY for statutory exclusion.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.49) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (2.43) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.49 |
| Practice expense RVU | 1.9 |
| Malpractice RVU | 0.04 |
| Total RVU | 2.43 |
| Medicare national rate | $81.16 |
| Global period | 0 days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $81.16 |
HOPD (APC 5051) Hospital outpatient department | $204.98 |
Common denial reasons
The recurring reasons claims for CPT 11056 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Lesion count does not match the code
- No qualifying systemic condition documented
- Q modifier missing or unsupported
- Too frequent under the local LCD
- E/M billed same day without separate problem
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01How many lesions is 11056?
02Can I bill 11055 twice instead of 11056?
03What makes 11056 covered by Medicare?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe names each lesion and its location, with the systemic condition and class findings, so the count and coverage both hold up.
See how Mira captures CPT 11056 documentation