CPT code 11421: Lesion excision, scalp, neck, hands, feet, genitalia2026 Medicare rate & RVUs in Florida

Reports surgical removal of a benign skin lesion on the scalp, neck, hands, feet, or genitalia when the lesion and margins measure 0.6–1 cm.

CMS RVU26DEffective Oct 1, 20263 payment localities23.1K Medicare services in 2024

Medicare pays $157.52–$172.35 for 11421 in the office in Florida, from Rest of Florida to Miami, FL. Which amount applies depends on the service address.

$157.52–$172.35Office (non-facility)
$99.72–$109.41Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Florida
  2. What 11421 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 11421 covers

This code represents full-thickness surgical removal of a benign skin lesion from the scalp, neck, hands, feet, or genitalia. Dermatologists, primary care clinicians, and surgeons commonly perform the procedure in an office or outpatient setting. The reported size is the excised diameter: the lesion’s greatest diameter plus the narrowest margins needed for complete removal. The code is not selected by the length of the incision or the size of the specimen after removal.

Document the lesion’s site, benign diagnosis, excised diameter, and removal method. Routine simple closure is included; a separately performed intermediate or complex repair may be reported when its requirements are met. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, 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.

Where 11421 pays more and less in Florida

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

3 payment localities

$157.52 to $172.35

$157.52$164.94$172.35
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.
11421 office and facility rates by payment locality
Payment localityOfficeFacility
Fort Lauderdale, FL$165.29$104.05
Miami, FL$172.35$109.41
Rest of Florida$157.52$99.72

How the 11421 rate is calculated

Each of 11421’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 · 11421

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.43

1.43 RVUs× 1.000 GPCI

Practice expense3.17

3.17 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

4.7700

Conversion factor

$33.4009

Medicare rate

$159.32

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

Payment rules and modifiers for 11421

11421 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11421

Lesion excision, scalp, neck, hands, feet, genitalia

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 · 11421

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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

11421 without 51 · national office

$159.32

Lesion excision, scalp, neck, hands, feet, genitalia

11421-51 · Second procedure: 50%

$79.66

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

11421 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 11421

    Lesion excision, scalp, neck, hands, feet, genitalia1.43 wRVU

    $159.32

  • 11420

    Benign lesion excision, scalp, neck, hands, feet, genitalia1 wRVU

    $124.92−$34.40

  • 11422

    Skin lesion excision, scalp, neck, hands, feet, genitalia1.64 wRVU

    $179.70+$20.38

  • 11401

    Benign lesion excision, trunk/extremities, 0.6–1 cm1.25 wRVU

    $154.98−$4.34

  • 11441

    Benign lesion excision, face, 0.6 to 1 cm1.49 wRVU

    $173.68+$14.36

How to choose

11420Benign lesion excisionScalp, neck, hands, feet, genitalia
Use 11420 for a smaller excised diameter in the same scalp, neck, hands, feet, or genitalia site group. Include the lesion and necessary margins when measuring.
11422Skin lesion excisionScalp, neck, hands, feet, genitalia
Use 11422 when the excised diameter falls in the next larger range for the same site group; 11421 is limited to 0.6–1 cm.
11401Benign lesion excisionTrunk/extremities, 0.6–1 cm
The size range may be similar, but 11401 is for the trunk, arms, or legs. Select the site-specific code before applying the diameter range.
11441Benign lesion excisionFace, 0.6 to 1 cm
11441 is for the face or mucous membrane site group, not the scalp, neck, hands, feet, or genitalia group covered by 11421.

11421 billing questions

How is 11421 distinguished from 11420 or 11422?

Use the excised diameter, including the lesion and the narrowest margins needed for removal. 11421 is for 0.6–1 cm; 11420 is the smaller size range and 11422 the next larger range.

Which body sites qualify for this code?

The site group includes the scalp, neck, hands, feet, and genitalia. A similar-sized lesion on the trunk, arms, or legs belongs to a different site group.

Can the closure be billed separately?

Routine simple closure is included in the excision. A separately performed intermediate or complex repair may be reported when the repair service and documentation support it.

Should modifier 50 be used for lesions on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; report the services according to the applicable lesion and procedure coding rules rather than using modifier 50.

What documentation supports the size selection?

Record the anatomical site, benign lesion diagnosis, and excised diameter, calculated from the lesion’s greatest diameter plus the narrowest margins. The incision length alone does not establish the code’s size.

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 11421PPRRVU2026_Oct_nonQPP.csv, line 1,316 (RVU26D)

Open CMS sourceHow we calculate rates

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