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CPT code 11401: Benign lesion excision, trunk/extremities, 0.6–1 cm2026 Medicare rate & RVUs in Vermont

Reports excision of a benign skin lesion on the trunk, arms, or legs when the lesion and narrowest margins measure 0.6 through 1.0 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality48.5K Medicare services in 2024

In Vermont, Medicare pays $151.26 for 11401 in the office and $91.41 when it’s performed in a hospital or facility.

$151.26Office (non-facility)
$91.41Hospital or facility
−2.4%vs the national office rate ($154.98)

Check a contract rate as a % of Medicare · 11401 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 11401 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 11401 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 11401 covers

A physician or other qualified practitioner excises a benign skin lesion from the trunk or an extremity, removing the lesion through the dermis with the margins needed for complete removal. Typical office cases include excision of a benign nevus or cyst from the back, arm, or leg. The code family is organized by both anatomic site and the diameter of the excised area, not by the lesion’s appearance alone.

Choose this level using the greatest diameter of the lesion plus the narrowest margins required for excision; document the site and measurement. Simple closure is included, while a separately performed intermediate or complex repair may be reported when its requirements are met and documented. Related postoperative visits during the 10-day global period are included. For multiple procedures in one session, CMS pays the highest-valued procedure in full and reduces the others to 50%. Assistant-at-surgery services are not paid; 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 Vermont compares for 11401

Across 109 of 109 payment localities, the office rate for 11401 runs from $137.18 in Arkansas to $204.78 in San Benito County, CA. Vermont pays $151.26. The RVUs are the same everywhere; the geographic indexes change the dollars.

11401 in Vermont vs other payment areas
  1. Vermont · this page$151.26
  2. Los Angeles, CA · California$174.64+$23.38
  3. Washington, DC area · District of Columbia$177.04+$25.78
  4. Miami, FL · Florida$167.57+$16.31
  5. Chicago, IL · Illinois$162.73+$11.47
  6. Manhattan, NY · New York$178.26+$27.00
  7. Alaska · Alaska$180.47+$29.21

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

Every other payment area

11401 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$139.18$86.28
ArkansasArkansas$137.18$85.25
ArizonaArizona$150.87$92.28
Bakersfield, CACalifornia$164.04$97.78
Chico, CACalifornia$163.57$97.31
El Centro, CACalifornia$163.59$97.33
Fresno, CACalifornia$163.57$97.31
Hanford, CACalifornia$163.57$97.31

11401 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$137.18

$184.18

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

View every state and territory as a table
11401 office rate range by state
State / territoryOffice rate rangeLocalities
AK$180.471
AL$139.181
AR$137.181
AZ$150.871
CA$163.57–$204.7829
CO$161.221
CT$165.241
DC$177.041
DE$153.351
FL$152.92–$167.573
GA$144.35–$157.912
GU$167.511
HI$167.511
IA$142.591
ID$143.531
IL$148.60–$162.734
IN$144.361
KS$141.971
KY$142.551
LA$142.35–$149.342
MA$160.28–$177.032
MD$156.25–$177.043
ME$144.33–$152.042
MI$146.28–$154.872
MN$154.351
MO$139.95–$149.813
MS$138.591
MT$154.971
NC$145.821
ND$151.811
NE$143.351
NH$158.741
NJ$167.09–$175.242
NM$147.101
NV$154.201
NY$148.00–$182.625
OH$145.641
OK$142.241
OR$152.96–$166.262
PA$145.84–$161.192
PR$156.091
RI$158.761
SC$145.981
SD$151.431
TN$142.691
TX$144.89–$160.718
UT$147.961
VA$151.57–$177.042
VI$156.091
VT$151.261
WA$159.96–$180.582
WI$146.751
WV$143.151
WY$153.591

See 11401 in every payment locality

How the 11401 rate is calculated

Each of 11401’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 · 11401

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.25

1.25 RVUs× 1.000 GPCI

Practice expense3.23

3.23 RVUs× 1.000 GPCI

Malpractice0.16

0.16 RVUs× 1.000 GPCI

Adjusted RVUs

4.6400

Conversion factor

$33.4009

Medicare rate

$154.98

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Vermont inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,310

Code
11401
Physician work
1.25
Practice expense
3.23
Malpractice
0.16

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 11401 in Vermont
ComponentRVULocality factorAdjusted
Physician work1.25× 1.0001.2500
Practice expense3.23× 0.9903.1977
Malpractice0.16× 0.5060.0810
Total RVUs4.5287
Conversion factor× 33.4009

Office rate, Vermont$151.26

Office: (1.25 × 1 + 3.23 × 0.99 + 0.16 × 0.506) × $33.4009 = $151.26

Facility: (1.25 × 1 + 1.42 × 0.99 + 0.16 × 0.506) × $33.4009 = $91.41

Open 11401 in the RVU calculator

Payment rules and modifiers for 11401

11401 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11401

Benign lesion excision, trunk/extremities, 0.6–1 cm

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are 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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 11401

Benign lesion excision, trunk/extremities, 0.6–1 cm

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

11401 without 51 · national office

$154.98

Benign lesion excision, trunk/extremities, 0.6–1 cm

11401-51 · Second procedure: 50%

$77.49

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

Codes related to 11401

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 11401
CodeHow it relatesOffice range, Vermont
Same family
11400Skin lesion excision, trunk, arm, or leg; 0.5 cm or lessTrunk or extremity benign-lesion excision at the smaller size level.$125.16
11402Skin lesion excision, trunk or extremity, 1.1–2 cmTrunk or extremity benign-lesion excision at the next larger size level.$166.86
11421Lesion excision, scalp, neck, hands, feet, genitaliaSame size range for benign-lesion excision on the scalp, neck, hands, or feet.$155.46
11441Benign lesion excision, face, 0.6 to 1 cmSame size range for benign-lesion excision on the face and related sites.$169.37
Often billed with
12031Wound repair, scalp, trunk, or extremityMay be reported for a qualifying intermediate repair of a trunk or extremity wound.$254.19

How 11401 has changed in Vermont

11401 · Office / nonfacility

$151.26

Effective 2026-10-01

The base rate is $3.43 higher than on 2025-10-01, moving from $147.83 to $151.26 (2.3%).

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

    $147.83changed to$151.26

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.28 changed to 1.25
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $153.46changed to$147.83

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.27 changed to 3.23

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $150.95changed to$153.46

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $156.15changed to$150.95

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.24 changed to 3.27
    • Malpractice RVU 0.18 changed to 0.16
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518

  5. January 1, 2023

    RVU23A

    $159.19changed to$156.15

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.22 changed to 3.24
    • Malpractice RVU 0.17 changed to 0.18
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $158.71changed to$159.19

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.18 changed to 3.22
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $155.57changed to$158.71

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.92 changed to 3.18
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $153.72changed to$155.57

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.83 changed to 2.92
    • Malpractice RVU 0.19 changed to 0.15
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $152.46changed to$153.72

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.80 changed to 2.83

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $150.34changed to$152.46

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.76 changed to 2.80
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $148.97changed to$150.34

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.74 changed to 2.76
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $149.62changed to$148.97

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.75 changed to 2.74
    • Malpractice RVU 0.18 changed to 0.19

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $148.87changed to$149.62

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $146.28changed to$148.87

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.67 changed to 2.75
    • Malpractice RVU 0.19 changed to 0.18
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$146.28

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$151.26$91.41RVU26D
2026-07-01$151.26$91.41RVU26C
2026-04-01$151.26$91.41RVU26B
2026-01-01$151.26$91.41RVU26A
2025-10-01$147.83$100.94RVU25D
2025-07-01$147.83$100.94RVU25C
2025-04-01$147.83$100.94RVU25B
2025-01-01$147.83$100.94RVU25A
2024-10-01$153.46$103.21RVU24D
2024-07-01$153.46$103.21RVU24C
2024-04-01$153.46$103.21RVU24B
2024-03-09$153.46$103.21RVU24AR
2024-01-01$150.95$101.53RVU24A
2023-10-01$156.15$104.46RVU23D
2023-07-01$156.15$104.46RVU23C
2023-04-01$156.15$104.46RVU23B
2023-01-01$156.15$104.46RVU23A
2022-10-01$159.19$104.80RVU22D
2022-07-01$159.19$104.80RVU22C
2022-04-01$159.19$104.80RVU22B
2022-01-01$159.19$104.80RVU22A
2021-10-01$158.71$104.22RVU21D
2021-07-01$158.71$104.22RVU21C
2021-04-01$158.71$104.22RVU21B
2021-01-01$158.71$104.22RVU21A
2020-10-01$155.57$105.00RVU20D
2020-07-01$155.57$105.00RVU20C
2020-04-01$155.57$105.00RVU20B
2020-01-01$155.57$105.00RVU20A
2019-10-01$153.72$105.81RVU19D
2019-07-01$153.72$105.81RVU19C
2019-04-01$153.72$105.81RVU19B
2019-01-01$153.72$105.81RVU19A
2018-10-01$152.46$105.32RVU18D
2018-07-01$152.46$105.32RVU18C
2018-04-01$152.46$105.32RVU18B
2018-01-01$152.46$105.32RVU18AR1
2017-10-01$150.34$105.03RVU17D
2017-07-01$150.34$105.03RVU17C
2017-04-01$150.34$105.03RVU17B
2017-01-01$150.34$105.03RVU17A
2016-10-01$148.97$104.03RVU16D
2016-07-01$148.97$104.03RVU16C
2016-04-01$148.97$104.03RVU16B
2016-01-01$148.97$104.03RVU16A
2015-10-01$149.62$104.52RVU15D
2015-07-01$149.62$104.52RVU15C
2015-04-01$148.87$104.00RVU15B
2015-01-01$148.87$104.00RVU15A
2014-10-01$146.28$102.67RVU14D
2014-07-01$146.28$102.67RVU14C
2014-04-01$146.28$102.67RVU14B
2014-01-01$146.28$102.67RVU14A
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 11401 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

11401 billing questions

How is the 0.6–1 cm size determined?

Measure the lesion together with the narrowest margins removed, using the greatest diameter of the excised area. Document the measurement and the anatomic site.

When should I use 11401 instead of 11400 or 11402?

Use 11401 for a trunk or extremity excision measuring 0.6 through 1.0 cm. Code 11400 is for the smaller size level, and 11402 is for the next larger level.

Does the excision code include wound closure?

Simple closure is included. A separately performed intermediate or complex repair may be reported when the repair independently meets the applicable requirements and is documented.

Can I use 11401 for a lesion on the face or scalp?

No. This code is for the trunk, arms, and legs; select the excision family for the actual site, such as the separate face or scalp, neck, hands, and feet families.

Are postoperative visits separately payable during the global period?

Related postoperative visits during the 10-day global period are included in the procedure.

How does CMS handle other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple procedure reduction, with payment at 50%.

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 11401PPRRVU2026_Oct_nonQPP.csv, line 1,310 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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