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CPT code 11404: Skin excision, trunk or extremity, 3.1–4 cm2026 Medicare rate & RVUs in South Carolina

Removal of a benign skin lesion on the trunk, arm, or leg when the lesion and required margins measure 3.1 to 4 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality16.2K Medicare services in 2024

In South Carolina, Medicare pays $217.91 for 11404 in the office and $144.76 when it’s performed in a hospital or facility.

$217.91Office (non-facility)
$144.76Hospital or facility
−5.7%vs the national office rate ($231.13)

Check a contract rate as a % of Medicare · 11404 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 11404 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Carolina
  2. What 11404 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 11404 covers

This service involves removing a benign skin lesion from the trunk or an extremity, such as a benign-appearing nevus or epidermal cyst. Dermatologists, primary care clinicians, and surgeons commonly perform it in an office or outpatient procedure setting. The code selection is based on the lesion’s greatest diameter plus the narrowest margins needed for removal, measured before excision—not the length of the resulting wound.

Document the lesion’s site and dimensions, the margins included in the excision, and the procedure performed. Routine simple closure is included; a separately reportable intermediate or complex repair may be coded when performed and documented. Related postoperative visits are included in the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and 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 South Carolina compares for 11404

Across 109 of 109 payment localities, the office rate for 11404 runs from $204.11 in Arkansas to $299.56 in San Benito County, CA. South Carolina pays $217.91. The RVUs are the same everywhere; the geographic indexes change the dollars.

11404 in South Carolina vs other payment areas
  1. South Carolina · this page$217.91
  2. Los Angeles, CA · California$257.42+$39.51
  3. Washington, DC area · District of Columbia$262.96+$45.05
  4. Miami, FL · Florida$255.68+$37.77
  5. Chicago, IL · Illinois$247.94+$30.03
  6. Manhattan, NY · New York$266.93+$49.02
  7. Alaska · Alaska$269.91+$52.00

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

Every other payment area

11404 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$207.13$137.86
ArkansasArkansas$204.11$136.11
ArizonaArizona$224.74$148.04
Bakersfield, CACalifornia$242.17$155.41
Chico, CACalifornia$241.15$154.39
El Centro, CACalifornia$241.21$154.45
Fresno, CACalifornia$241.15$154.39
Hanford, CACalifornia$241.15$154.39

11404 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.

$204.11

$270.36

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

View every state and territory as a table
11404 office rate range by state
State / territoryOffice rate rangeLocalities
AK$269.911
AL$207.131
AR$204.111
AZ$224.741
CA$241.15–$299.5629
CO$238.951
CT$246.611
DC$262.961
DE$228.461
FL$230.57–$255.683
GA$217.21–$236.162
GU$246.661
HI$246.661
IA$211.111
ID$212.771
IL$224.83–$247.944
IN$213.981
KS$210.741
KY$213.431
LA$213.34–$223.902
MA$237.76–$261.792
MD$232.64–$262.963
ME$214.56–$225.342
MI$219.61–$234.122
MN$227.031
MO$210.08–$223.943
MS$207.101
MT$231.111
NC$216.721
ND$223.991
NE$212.081
NH$235.791
NJ$248.88–$260.342
NM$221.081
NV$229.281
NY$220.05–$274.255
OH$218.151
OK$212.371
OR$226.96–$245.842
PA$218.15–$240.862
PR$232.611
RI$236.101
SC$217.911
SD$223.151
TN$211.891
TX$216.75–$238.628
UT$220.891
VA$225.04–$262.962
VI$232.611
VT$223.691
WA$237.12–$266.492
WI$216.501
WV$216.631
WY$228.011

See 11404 in every payment locality

How the 11404 rate is calculated

Each of 11404’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 · 11404

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.06

2.06 RVUs× 1.000 GPCI

Practice expense4.50

4.50 RVUs× 1.000 GPCI

Malpractice0.36

0.36 RVUs× 1.000 GPCI

Adjusted RVUs

6.9200

Conversion factor

$33.4009

Medicare rate

$231.13

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

The exact South Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,313

Code
11404
Physician work
2.06
Practice expense
4.50
Malpractice
0.36

GPCI2026.csv

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Office calculation for 11404 in South Carolina
ComponentRVULocality factorAdjusted
Physician work2.06× 1.0002.0600
Practice expense4.50× 0.9244.1580
Malpractice0.36× 0.8500.3060
Total RVUs6.5240
Conversion factor× 33.4009

Office rate, South Carolina$217.91

Office: (2.06 × 1 + 4.5 × 0.924 + 0.36 × 0.85) × $33.4009 = $217.91

Facility: (2.06 × 1 + 2.13 × 0.924 + 0.36 × 0.85) × $33.4009 = $144.76

Open 11404 in the RVU calculator

Payment rules and modifiers for 11404

11404 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11404

Skin excision, trunk or extremity, 3.1–4 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 · 11404

Skin excision, trunk or extremity, 3.1–4 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

11404 without 51 · national office

$231.13

Skin excision, trunk or extremity, 3.1–4 cm

11404-51 · Second procedure: 50%

$115.57

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 11404

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

Codes related to 11404
CodeHow it relatesOffice range, South Carolina
Same family
11403Benign lesion excision, trunk or limb, 2.1–3 cmSame trunk and extremity sites, for the smaller adjacent excision-size range.$188.48
11406Skin lesion excision, trunk or extremity, over 4 cmSame trunk and extremity sites, for lesions with excision diameter greater than 4 cm.$315.44
11424Lesion excision, scalp, neck, hands, feet, genitaliaSame size range for lesions on the hand, foot, neck, or genital area.$230.52
11444Skin excision, face, 3.1–4 cmSame size range for benign lesions excised from the face.$273.17
Often billed with
12032Intermediate repair, 2.6–7.5 cm, scalp/trunk/extremitiesMay be separately reported for a qualifying intermediate repair of the trunk or extremity.$282.75

How 11404 has changed in South Carolina

11404 · Office / nonfacility

$217.91

Effective 2026-10-01

The base rate is $13.16 higher than on 2025-10-01, moving from $204.75 to $217.91 (6.4%).

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

    $204.75changed to$217.91

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.11 changed to 2.06
    • Practice expense RVU 4.30 changed to 4.50
    • Practice expense GPCI 0.913 changed to 0.924
    • Malpractice GPCI 0.817 changed to 0.850

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $210.74changed to$204.75

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.31 changed to 4.30
    • Malpractice RVU 0.35 changed to 0.36

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $207.30changed to$210.74

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $212.16changed to$207.30

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.28 changed to 4.31
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.756 changed to 0.817

  5. January 1, 2023

    RVU23A

    $214.01changed to$212.16

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.25 changed to 4.28
    • Malpractice RVU 0.34 changed to 0.35
    • Practice expense GPCI 0.903 changed to 0.908
    • Malpractice GPCI 0.695 changed to 0.756

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $214.52changed to$214.01

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.21 changed to 4.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $211.04changed to$214.52

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.88 changed to 4.21
    • Malpractice RVU 0.35 changed to 0.34
    • Practice expense GPCI 0.907 changed to 0.903
    • Malpractice GPCI 0.624 changed to 0.695

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $207.73changed to$211.04

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.77 changed to 3.88
    • Malpractice RVU 0.39 changed to 0.35
    • Practice expense GPCI 0.912 changed to 0.907
    • Malpractice GPCI 0.553 changed to 0.624

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $206.31changed to$207.73

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.74 changed to 3.77
    • Malpractice RVU 0.38 changed to 0.39

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $205.37changed to$206.31

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.69 changed to 3.74
    • Malpractice RVU 0.39 changed to 0.38
    • Malpractice GPCI 0.634 changed to 0.553

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $205.37changed to$205.37

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.67 changed to 3.69
    • Malpractice GPCI 0.715 changed to 0.634

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $205.27changed to$205.37

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.66 changed to 3.67
    • Malpractice RVU 0.37 changed to 0.39

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $204.25changed to$205.27

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $200.82changed to$204.25

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.60 changed to 3.66
    • Malpractice RVU 0.35 changed to 0.37
    • Practice expense GPCI 0.911 changed to 0.912
    • Malpractice GPCI 0.618 changed to 0.715

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $203.28changed to$200.82

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.04 changed to 3.60
    • Malpractice RVU 0.37 changed to 0.35
    • Practice expense GPCI 0.909 changed to 0.911
    • Malpractice GPCI 0.520 changed to 0.618

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $203.28

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$217.91$144.76RVU26D
2026-07-01$217.91$144.76RVU26C
2026-04-01$217.91$144.76RVU26B
2026-01-01$217.91$144.76RVU26A
2025-10-01$204.75$153.37RVU25D
2025-07-01$204.75$153.37RVU25C
2025-04-01$204.75$153.37RVU25B
2025-01-01$204.75$153.37RVU25A
2024-10-01$210.74$156.04RVU24D
2024-07-01$210.74$156.04RVU24C
2024-04-01$210.74$156.04RVU24B
2024-03-09$210.74$156.04RVU24AR
2024-01-01$207.30$153.49RVU24A
2023-10-01$212.16$155.85RVU23D
2023-07-01$212.16$155.85RVU23C
2023-04-01$212.16$155.85RVU23B
2023-01-01$212.16$155.85RVU23A
2022-10-01$214.01$155.26RVU22D
2022-07-01$214.01$155.26RVU22C
2022-04-01$214.01$155.26RVU22B
2022-01-01$214.01$155.26RVU22A
2021-10-01$214.52$154.65RVU21D
2021-07-01$214.52$154.65RVU21C
2021-04-01$214.52$154.65RVU21B
2021-01-01$214.52$154.65RVU21A
2020-10-01$211.04$156.04RVU20D
2020-07-01$211.04$156.04RVU20C
2020-04-01$211.04$156.04RVU20B
2020-01-01$211.04$156.04RVU20A
2019-10-01$207.73$155.14RVU19D
2019-07-01$207.73$155.14RVU19C
2019-04-01$207.73$155.14RVU19B
2019-01-01$207.73$155.14RVU19A
2018-10-01$206.31$154.77RVU18D
2018-07-01$206.31$154.77RVU18C
2018-04-01$206.31$154.77RVU18B
2018-01-01$206.31$154.77RVU18AR1
2017-10-01$205.37$155.30RVU17D
2017-07-01$205.37$155.30RVU17C
2017-04-01$205.37$155.30RVU17B
2017-01-01$205.37$155.30RVU17A
2016-10-01$205.37$155.74RVU16D
2016-07-01$205.37$155.74RVU16C
2016-04-01$205.37$155.74RVU16B
2016-01-01$205.37$155.74RVU16A
2015-10-01$205.27$156.11RVU15D
2015-07-01$205.27$156.11RVU15C
2015-04-01$204.25$155.34RVU15B
2015-01-01$204.25$155.34RVU15A
2014-10-01$200.82$152.19RVU14D
2014-07-01$200.82$152.19RVU14C
2014-04-01$200.82$152.19RVU14B
2014-01-01$200.82$152.19RVU14A
2013-10-01$203.28$151.32RVU13D
2013-07-01$203.28$151.32RVU13C
2013-04-01$203.28$151.32RVU13B
2013-01-01$203.28$151.32RVU13AR

Price 11404 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Abney Crossroads
  • Adams Run
  • Aiken
  • Alcolu
  • Allendale
  • Anderson
  • Andrews

Browse all communities in South Carolina

11404 billing questions

How do I distinguish 11404 from 11403 or 11406?

Measure the lesion together with the margins required for excision. Use 11404 when that measurement is 3.1–4 cm; 11403 is for the smaller adjacent size range, and 11406 is for a measurement greater than 4 cm.

Can I report 11404 for a lesion on the hand or face?

No. This code is for the trunk and extremities other than the anatomic areas assigned to separate code series. Hand, foot, neck, and genital sites use the 11420–11426 series; facial sites use the 11440–11446 series.

Is wound closure included?

Simple closure is included in the excision. A separately reportable intermediate or complex repair may be coded when that repair is actually performed and documented.

Does the 10-day global period include postoperative visits?

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

Can modifier 50 be used for lesions removed on both sides?

No. The bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

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 11404PPRRVU2026_Oct_nonQPP.csv, line 1,313 (RVU26D)
Geographic factors for South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

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