CPT code 11420: Benign lesion excision, scalp, neck, hands, feet, genitalia2026 Medicare rate & RVUs in Texas
Reports excision of a benign skin lesion measuring 0.5 cm or less, including margins, on the scalp, neck, hands, feet, or genitalia.
Medicare pays $116.75–$129.66 for 11420 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 11420 covers
This code covers surgical removal of a small benign skin lesion from the scalp, neck, a hand, a foot, or the genitalia. Dermatologists, primary care clinicians, and surgeons may perform the procedure in an office or facility. The coded size is the greatest diameter of the lesion plus the margins removed, not the lesion alone. A suspected nevus or cyst may be removed for treatment or diagnosis; the record should identify the site and document the excised diameter and benign clinical assessment.
Choose this code only when the site falls within this group and the excised diameter is 0.5 cm or less. Use the appropriate sibling code when the diameter is larger, or a different site-specific code for another body region. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; 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.
Where 11420 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$116.75 to $129.66
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $129.66 | $78.07 |
| Beaumont, TX | $116.75 | $72.38 |
| Brazoria, TX | $123.59 | $75.26 |
| Dallas, TX | $124.35 | $75.78 |
| Fort Worth, TX | $123.52 | $75.43 |
| Galveston, TX | $123.94 | $75.52 |
| Houston, TX | $125.95 | $77.53 |
| Rest of Texas | $120.08 | $73.80 |
How the 11420 rate is calculated
Each of 11420’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 · 11420
RVUs × geographic indexes × conversion factor
Work1.00
1.00 RVUs× 1.000 GPCI
Practice expense2.63
2.63 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
3.7400
Conversion factor
$33.4009
Medicare rate
$124.92
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11420
11420 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11420
Benign lesion excision, scalp, neck, hands, feet, genitalia
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 11420
Benign lesion excision, scalp, neck, hands, feet, genitalia
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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11420 without 51 · national office
$124.92
Benign lesion excision, scalp, neck, hands, feet, genitalia
11420-51 · Second procedure: 50%
$62.46
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%).
11420 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 11421Lesion excisionScalp, neck, hands, feet, genitalia
- The site group is the same, but 11421 applies when the excised diameter is 0.6 to 1.0 cm; 11420 is for 0.5 cm or less.
- 11400Skin lesion excisionTrunk, arm, or leg; 0.5 cm or less
- Both report excision of a small benign lesion, but 11400 is for trunk or extremity sites outside the scalp, neck, hands, feet, and genitalia group.
- 11440Lesion excisionFace, 0.5 cm or less
- Use 11440 for benign lesion excision on the face, ears, eyelids, nose, or lips, not the site group covered by 11420.
- 11200Skin tag removalUp to 15 lesions
- Use 11200 for skin-tag removal. Code 11420 is for excision of a benign lesion at a specified site, with size measured including margins.
11420 billing questions
How is the lesion size determined?
Use the excised diameter, which includes the lesion and the margins removed. The documentation should support a diameter of 0.5 cm or less.
When should I choose 11421 instead?
Choose 11421 for a lesion at one of the same sites when the excised diameter is 0.6 to 1.0 cm. Code 11420 is limited to 0.5 cm or less.
Can modifier 50 be used for lesions on both sides?
No. Modifier 50 is inappropriate for this code. It describes an individual lesion excision, not a bilateral procedure.
Are postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure reduction and paid at 50%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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
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