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

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, 2026One payment locality23.1K Medicare services in 2024

In Queens, NY, Medicare pays $184.16 for 11421 in the office and $112.70 when it’s performed in a hospital or facility.

$184.16Office (non-facility)
$112.70Hospital or facility
+15.6%vs the national office rate ($159.32)

Check a contract rate as a % of Medicare · 11421 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 11421 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 11421 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 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.

How Queens, NY compares for 11421

Across 109 of 109 payment localities, the office rate for 11421 runs from $141.64 in Arkansas to $208.74 in San Benito County, CA. Queens, NY pays $184.16. The RVUs are the same everywhere; the geographic indexes change the dollars.

11421 in Queens, NY vs other payment areas
  1. Queens, NY · this page$184.16
  2. Manhattan, NY · New York$182.86−$1.30
  3. NYC suburbs and Long Island, NY · New York$187.26+$3.10
  4. Poughkeepsie and northern NYC suburbs, NY · New York$172.72−$11.44
  5. Rest of New York · New York$152.34−$31.82
  6. Los Angeles, CA · California$178.75−$5.41
  7. Washington, DC area · District of Columbia$181.39−$2.77

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

Every other payment area

11421 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$172.35$109.41
Chicago, ILIllinois$167.54$106.78
AlaskaAlaska$187.54$123.15
AlabamaAlabama$143.62$90.72
ArkansasArkansas$141.64$89.71
ArizonaArizona$155.22$96.64
Bakersfield, CACalifornia$168.17$101.91
Chico, CACalifornia$167.66$101.40

11421 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.

$141.64

$188.20

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

View every state and territory as a table
11421 office rate range by state
State / territoryOffice rate rangeLocalities
AK$187.541
AL$143.621
AR$141.641
AZ$155.221
CA$167.66–$208.7429
CO$165.431
CT$169.621
DC$181.391
DE$157.721
FL$157.52–$172.353
GA$148.98–$162.302
GU$171.441
HI$171.441
IA$146.901
ID$147.861
IL$153.31–$167.544
IN$148.671
KS$146.341
KY$147.091
LA$146.91–$153.852
MA$164.55–$181.202
MD$160.60–$181.393
ME$148.71–$156.272
MI$150.84–$159.512
MN$158.401
MO$144.56–$154.253
MS$143.121
MT$159.311
NC$150.181
ND$155.951
NE$147.641
NH$162.951
NJ$171.52–$179.662
NM$151.681
NV$158.481
NY$152.34–$187.265
OH$150.161
OK$146.731
OR$157.21–$170.392
PA$150.33–$165.622
PR$160.401
RI$163.111
SC$150.421
SD$155.551
TN$147.061
TX$149.39–$164.918
UT$152.391
VA$155.85–$181.392
VI$160.401
VT$155.461
WA$164.20–$184.712
WI$150.951
WV$147.901
WY$157.851

See 11421 in every payment locality

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.

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,316

Code
11421
Physician work
1.43
Practice expense
3.17
Malpractice
0.17

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 11421 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work1.43× 1.0641.5215
Practice expense3.17× 1.1823.7469
Malpractice0.17× 1.4420.2451
Total RVUs5.5136
Conversion factor× 33.4009

Office rate, Queens, NY$184.16

Office: (1.43 × 1.064 + 3.17 × 1.182 + 0.17 × 1.442) × $33.4009 = $184.16

Facility: (1.43 × 1.064 + 1.36 × 1.182 + 0.17 × 1.442) × $33.4009 = $112.70

Open 11421 in the RVU calculator

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

Codes related to 11421

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

Codes related to 11421
CodeHow it relatesOffice range, Queens, NY
Same family
11420Benign lesion excision, scalp, neck, hands, feet, genitaliaSame site group for a smaller excised diameter.$144.67
11422Skin lesion excision, scalp, neck, hands, feet, genitaliaSame site group for the next larger excised-diameter range.$207.76
Used instead
11401Benign lesion excision, trunk/extremities, 0.6–1 cmBenign lesion excision in the trunk, arms, or legs for its specified size range.$179.65
11441Benign lesion excision, face, 0.6 to 1 cmBenign lesion excision in the face or mucous membrane site group for its specified size range.$201.07
Often billed with
88305Tissue pathology exam, level IV specimenMay be reported by the pathology service when the excised specimen receives the corresponding examination.$80.20

How 11421 has changed in Queens, NY

11421 · Office / nonfacility

$184.16

Effective 2026-10-01

The base rate is $4.19 higher than on 2025-10-01, moving from $179.97 to $184.16 (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

    $179.97changed to$184.16

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.47 changed to 1.43
    • Practice expense RVU 3.15 changed to 3.17
    • Malpractice RVU 0.16 changed to 0.17
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $186.88changed to$179.97

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.18 changed to 3.15
    • Malpractice RVU 0.17 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $183.83changed to$186.88

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $195.21changed to$183.83

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.16 changed to 3.18
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $202.39changed to$195.21

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.13 changed to 3.16
    • Malpractice RVU 0.17 changed to 0.18
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $201.85changed to$202.39

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.10 changed to 3.13
    • Malpractice RVU 0.16 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $198.07changed to$201.85

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.89 changed to 3.10
    • Malpractice RVU 0.18 changed to 0.16
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $192.98changed to$198.07

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.82 changed to 2.89
    • Malpractice RVU 0.20 changed to 0.18
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $192.33changed to$192.98

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.81 changed to 2.82

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $190.23changed to$192.33

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.77 changed to 2.81
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $189.47changed to$190.23

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.76 changed to 2.77
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $190.23changed to$189.47

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.78 changed to 2.76
    • Malpractice RVU 0.19 changed to 0.20

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $189.29changed to$190.23

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $185.68changed to$189.29

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.71 changed to 2.78
    • Malpractice RVU 0.21 changed to 0.19
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $188.28changed to$185.68

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.05 changed to 2.71
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $188.28

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$184.16$112.70RVU26D
2026-07-01$184.16$112.70RVU26C
2026-04-01$184.16$112.70RVU26B
2026-01-01$184.16$112.70RVU26A
2025-10-01$179.97$123.15RVU25D
2025-07-01$179.97$123.15RVU25C
2025-04-01$179.97$123.15RVU25B
2025-01-01$179.97$123.15RVU25A
2024-10-01$186.88$126.02RVU24D
2024-07-01$186.88$126.02RVU24C
2024-04-01$186.88$126.02RVU24B
2024-03-09$186.88$126.02RVU24AR
2024-01-01$183.83$123.96RVU24A
2023-10-01$195.21$131.96RVU23D
2023-07-01$195.21$131.96RVU23C
2023-04-01$195.21$131.96RVU23B
2023-01-01$195.21$131.96RVU23A
2022-10-01$202.39$135.67RVU22D
2022-07-01$202.39$135.67RVU22C
2022-04-01$202.39$135.67RVU22B
2022-01-01$202.39$135.67RVU22A
2021-10-01$201.85$135.01RVU21D
2021-07-01$201.85$135.01RVU21C
2021-04-01$201.85$135.01RVU21B
2021-01-01$201.85$135.01RVU21A
2020-10-01$198.07$136.29RVU20D
2020-07-01$198.07$136.29RVU20C
2020-04-01$198.07$136.29RVU20B
2020-01-01$198.07$136.29RVU20A
2019-10-01$192.98$135.03RVU19D
2019-07-01$192.98$135.03RVU19C
2019-04-01$192.98$135.03RVU19B
2019-01-01$192.98$135.03RVU19A
2018-10-01$192.33$134.88RVU18D
2018-07-01$192.33$134.88RVU18C
2018-04-01$192.33$134.88RVU18B
2018-01-01$192.33$134.88RVU18AR1
2017-10-01$190.23$135.11RVU17D
2017-07-01$190.23$135.11RVU17C
2017-04-01$190.23$135.11RVU17B
2017-01-01$190.23$135.11RVU17A
2016-10-01$189.47$134.09RVU16D
2016-07-01$189.47$134.09RVU16C
2016-04-01$189.47$134.09RVU16B
2016-01-01$189.47$134.09RVU16A
2015-10-01$190.23$134.22RVU15D
2015-07-01$190.23$134.22RVU15C
2015-04-01$189.29$133.56RVU15B
2015-01-01$189.29$133.56RVU15A
2014-10-01$185.68$132.08RVU14D
2014-07-01$185.68$132.08RVU14C
2014-04-01$185.68$132.08RVU14B
2014-01-01$185.68$132.08RVU14A
2013-10-01$188.28$130.14RVU13D
2013-07-01$188.28$130.14RVU13C
2013-04-01$188.28$130.14RVU13B
2013-01-01$188.28$130.14RVU13AR

Price 11421 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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