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

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 South Dakota, Medicare pays $155.55 for 11421 in the office and $95.10 when it’s performed in a hospital or facility.

$155.55Office (non-facility)
$95.10Hospital or facility
−2.4%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 South Dakota
  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 South Dakota 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. South Dakota pays $155.55. The RVUs are the same everywhere; the geographic indexes change the dollars.

11421 in South Dakota vs other payment areas
  1. South Dakota · this page$155.55
  2. Los Angeles, CA · California$178.75+$23.20
  3. Washington, DC area · District of Columbia$181.39+$25.84
  4. Miami, FL · Florida$172.35+$16.80
  5. Chicago, IL · Illinois$167.54+$11.99
  6. Manhattan, NY · New York$182.86+$27.31
  7. Alaska · Alaska$187.54+$31.99

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

Every other payment area

11421 in every other Medicare payment locality
Payment localityOfficeFacility
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
El Centro, CACalifornia$167.69$101.43
Fresno, CACalifornia$167.66$101.40
Hanford, CACalifornia$167.66$101.40

11421 rates by state

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

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 South Dakota 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

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 11421 in South Dakota
ComponentRVULocality factorAdjusted
Physician work1.43× 1.0001.4300
Practice expense3.17× 1.0003.1700
Malpractice0.17× 0.3360.0571
Total RVUs4.6571
Conversion factor× 33.4009

Office rate, South Dakota$155.55

Office: (1.43 × 1 + 3.17 × 1 + 0.17 × 0.336) × $33.4009 = $155.55

Facility: (1.43 × 1 + 1.36 × 1 + 0.17 × 0.336) × $33.4009 = $95.10

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

How 11421 has changed in South Dakota

11421 · Office / nonfacility

$155.55

Effective 2026-10-01

The base rate is $4.13 higher than on 2025-10-01, moving from $151.42 to $155.55 (2.7%).

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

    $151.42changed to$155.55

    • 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
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $156.95changed to$151.42

    • 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

    $154.39changed to$156.95

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $159.12changed to$154.39

    • 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
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $161.23changed to$159.12

    • 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
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $161.40changed to$161.23

    • 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

    $159.74changed to$161.40

    • 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
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $157.41changed to$159.74

    • 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
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $156.88changed to$157.41

    • 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

    $155.00changed to$156.88

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.77 changed to 2.81
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $154.32changed to$155.00

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.76 changed to 2.77
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $155.45changed to$154.32

    • 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

    $154.67changed to$155.45

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $152.87changed to$154.67

    • 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
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $157.02changed to$152.87

    • 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
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $157.02

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$155.55$95.10RVU26D
2026-07-01$155.55$95.10RVU26C
2026-04-01$155.55$95.10RVU26B
2026-01-01$155.55$95.10RVU26A
2025-10-01$151.42$103.87RVU25D
2025-07-01$151.42$103.87RVU25C
2025-04-01$151.42$103.87RVU25B
2025-01-01$151.42$103.87RVU25A
2024-10-01$156.95$106.02RVU24D
2024-07-01$156.95$106.02RVU24C
2024-04-01$156.95$106.02RVU24B
2024-03-09$156.95$106.02RVU24AR
2024-01-01$154.39$104.29RVU24A
2023-10-01$159.12$106.93RVU23D
2023-07-01$159.12$106.93RVU23C
2023-04-01$159.12$106.93RVU23B
2023-01-01$159.12$106.93RVU23A
2022-10-01$161.23$106.90RVU22D
2022-07-01$161.23$106.90RVU22C
2022-04-01$161.23$106.90RVU22B
2022-01-01$161.23$106.90RVU22A
2021-10-01$161.40$106.97RVU21D
2021-07-01$161.40$106.97RVU21C
2021-04-01$161.40$106.97RVU21B
2021-01-01$161.40$106.97RVU21A
2020-10-01$159.74$108.85RVU20D
2020-07-01$159.74$108.85RVU20C
2020-04-01$159.74$108.85RVU20B
2020-01-01$159.74$108.85RVU20A
2019-10-01$157.41$109.12RVU19D
2019-07-01$157.41$109.12RVU19C
2019-04-01$157.41$109.12RVU19B
2019-01-01$157.41$109.12RVU19A
2018-10-01$156.88$109.00RVU18D
2018-07-01$156.88$109.00RVU18C
2018-04-01$156.88$109.00RVU18B
2018-01-01$156.88$109.00RVU18AR1
2017-10-01$155.00$109.07RVU17D
2017-07-01$155.00$109.07RVU17C
2017-04-01$155.00$109.07RVU17B
2017-01-01$155.00$109.07RVU17A
2016-10-01$154.32$108.13RVU16D
2016-07-01$154.32$108.13RVU16C
2016-04-01$154.32$108.13RVU16B
2016-01-01$154.32$108.13RVU16A
2015-10-01$155.45$108.73RVU15D
2015-07-01$155.45$108.73RVU15C
2015-04-01$154.67$108.19RVU15B
2015-01-01$154.67$108.19RVU15A
2014-10-01$152.87$108.09RVU14D
2014-07-01$152.87$108.09RVU14C
2014-04-01$152.87$108.09RVU14B
2014-01-01$152.87$108.09RVU14A
2013-10-01$157.02$108.36RVU13D
2013-07-01$157.02$108.36RVU13C
2013-04-01$157.02$108.36RVU13B
2013-01-01$157.02$108.36RVU13AR

Price 11421 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

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 South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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