CPT code 11421: Lesion excision, scalp, neck, hands, feet, genitalia2026 Medicare rate & RVUs in Tennessee
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.
In Tennessee, Medicare pays $147.06 for 11421 in the office and $92.10 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Tennessee 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. Tennessee pays $147.06. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Tennessee · this page$147.06
- Los Angeles, CA · California$178.75+$31.69
- Washington, DC area · District of Columbia$181.39+$34.33
- Miami, FL · Florida$172.35+$25.29
- Chicago, IL · Illinois$167.54+$20.48
- Manhattan, NY · New York$182.86+$35.80
- Alaska · Alaska$187.54+$40.48
Other areas in Tennessee first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $167.66 | $101.40 |
| Merced, CACalifornia | $167.66 | $101.40 |
| Modesto, CACalifornia | $167.66 | $101.40 |
| Napa, CACalifornia | $193.21 | $113.53 |
| Oxnard, CACalifornia | $177.79 | $106.33 |
| Redding, CACalifornia | $167.66 | $101.40 |
| Rest of CaliforniaCalifornia | $167.66 | $101.40 |
| Riverside, CACalifornia | $169.51 | $103.25 |
| Sacramento, CACalifornia | $175.67 | $105.36 |
| Salinas, CACalifornia | $175.00 | $104.94 |
| San Diego, CACalifornia | $178.91 | $106.60 |
| Marin County, CACalifornia | $204.20 | $118.96 |
| San Francisco, CACalifornia | $204.01 | $118.76 |
| San Benito County, CACalifornia | $208.74 | $121.56 |
| Santa Clara County, CACalifornia | $207.95 | $120.77 |
| San Luis Obispo, CACalifornia | $172.22 | $103.36 |
| Santa Cruz, CACalifornia | $180.46 | $107.00 |
| Santa Maria, CACalifornia | $175.60 | $105.11 |
| Santa Rosa, CACalifornia | $182.26 | $108.02 |
| Stockton, CACalifornia | $167.66 | $101.40 |
| Vallejo, CACalifornia | $192.93 | $113.25 |
| Visalia, CACalifornia | $167.66 | $101.40 |
| Yuba City, CACalifornia | $167.66 | $101.40 |
| ColoradoColorado | $165.43 | $101.10 |
| ConnecticutConnecticut | $169.62 | $104.51 |
| DelawareDelaware | $157.72 | $97.99 |
| Fort Lauderdale, FLFlorida | $165.29 | $104.05 |
| Rest of FloridaFlorida | $157.52 | $99.72 |
| Atlanta, GAGeorgia | $162.30 | $100.88 |
| Rest of GeorgiaGeorgia | $148.98 | $95.05 |
| Hawaii, Guam, HIHawaii | $171.44 | $102.70 |
| IowaIowa | $146.90 | $91.58 |
| IdahoIdaho | $147.86 | $92.24 |
| East St. Louis, ILIllinois | $156.61 | $100.99 |
| Rest of IllinoisIllinois | $153.31 | $98.11 |
| Suburban Chicago, ILIllinois | $166.90 | $104.81 |
| IndianaIndiana | $148.67 | $92.63 |
| KansasKansas | $146.34 | $91.69 |
| KentuckyKentucky | $147.09 | $93.34 |
| New Orleans, LALouisiana | $153.85 | $96.96 |
| Rest of LouisianaLouisiana | $146.91 | $93.40 |
| Metropolitan Boston, MAMassachusetts | $181.20 | $109.01 |
| Rest of MassachusettsMassachusetts | $164.55 | $100.89 |
| Baltimore area, MDMaryland | $169.16 | $104.29 |
| Rest of MarylandMaryland | $160.60 | $99.42 |
| Rest of MaineMaine | $148.71 | $93.09 |
| Southern Maine, MEMaine | $156.27 | $96.36 |
| Detroit, MIMichigan | $159.51 | $101.17 |
| Rest of MichiganMichigan | $150.84 | $95.65 |
| MinnesotaMinnesota | $158.40 | $96.19 |
| Metropolitan Kansas City, MOMissouri | $152.73 | $95.97 |
| Metropolitan St. Louis, MOMissouri | $154.25 | $96.70 |
| Rest of MissouriMissouri | $144.56 | $92.45 |
| MississippiMississippi | $143.12 | $91.07 |
| MontanaMontana | $159.31 | $98.86 |
| North CarolinaNorth Carolina | $150.18 | $93.77 |
| North DakotaNorth Dakota | $155.95 | $95.49 |
| NebraskaNebraska | $147.64 | $91.84 |
| New HampshireNew Hampshire | $162.95 | $100.02 |
| Northern New JerseyNew Jersey | $179.66 | $109.53 |
| Rest of New JerseyNew Jersey | $171.52 | $105.51 |
| New MexicoNew Mexico | $151.68 | $96.24 |
| NevadaNevada | $158.48 | $97.96 |
| NYC suburbs and Long Island, NYNew York | $187.26 | $115.38 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $172.72 | $106.52 |
| Queens, NYNew York | $184.16 | $112.70 |
| Rest of New YorkNew York | $152.34 | $94.91 |
| OhioOhio | $150.16 | $94.96 |
| OklahomaOklahoma | $146.73 | $92.74 |
| Portland, OROregon | $170.39 | $103.22 |
| Rest of OregonOregon | $157.21 | $97.00 |
| Metropolitan Philadelphia, PAPennsylvania | $165.62 | $102.68 |
| Rest of PennsylvaniaPennsylvania | $150.33 | $94.83 |
| Puerto RicoPuerto Rico | $160.40 | $99.28 |
| Rhode IslandRhode Island | $163.11 | $100.66 |
| South CarolinaSouth Carolina | $150.42 | $94.56 |
| South DakotaSouth Dakota | $155.55 | $95.10 |
| Austin, TXTexas | $164.91 | $100.95 |
| Beaumont, TXTexas | $149.39 | $94.38 |
| Brazoria, TXTexas | $157.50 | $97.59 |
| Dallas, TXTexas | $158.52 | $98.31 |
| Fort Worth, TXTexas | $157.54 | $97.93 |
| Galveston, TXTexas | $157.99 | $97.95 |
| Houston, TXTexas | $161.10 | $101.07 |
| Rest of TexasTexas | $153.37 | $96.00 |
| UtahUtah | $152.39 | $95.56 |
| VirginiaVirginia | $155.85 | $96.43 |
| Virgin Islands, VIUnited States Virgin Islands | $160.40 | $99.28 |
| VermontVermont | $155.46 | $95.61 |
| Rest of WashingtonWashington | $164.20 | $100.54 |
| King County, WAWashington | $184.71 | $110.53 |
| WisconsinWisconsin | $150.95 | $93.03 |
| West VirginiaWest Virginia | $147.90 | $95.36 |
| WyomingWyoming | $157.85 | $97.39 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $187.54 | 1 |
| AL | $143.62 | 1 |
| AR | $141.64 | 1 |
| AZ | $155.22 | 1 |
| CA | $167.66–$208.74 | 29 |
| CO | $165.43 | 1 |
| CT | $169.62 | 1 |
| DC | $181.39 | 1 |
| DE | $157.72 | 1 |
| FL | $157.52–$172.35 | 3 |
| GA | $148.98–$162.30 | 2 |
| GU | $171.44 | 1 |
| HI | $171.44 | 1 |
| IA | $146.90 | 1 |
| ID | $147.86 | 1 |
| IL | $153.31–$167.54 | 4 |
| IN | $148.67 | 1 |
| KS | $146.34 | 1 |
| KY | $147.09 | 1 |
| LA | $146.91–$153.85 | 2 |
| MA | $164.55–$181.20 | 2 |
| MD | $160.60–$181.39 | 3 |
| ME | $148.71–$156.27 | 2 |
| MI | $150.84–$159.51 | 2 |
| MN | $158.40 | 1 |
| MO | $144.56–$154.25 | 3 |
| MS | $143.12 | 1 |
| MT | $159.31 | 1 |
| NC | $150.18 | 1 |
| ND | $155.95 | 1 |
| NE | $147.64 | 1 |
| NH | $162.95 | 1 |
| NJ | $171.52–$179.66 | 2 |
| NM | $151.68 | 1 |
| NV | $158.48 | 1 |
| NY | $152.34–$187.26 | 5 |
| OH | $150.16 | 1 |
| OK | $146.73 | 1 |
| OR | $157.21–$170.39 | 2 |
| PA | $150.33–$165.62 | 2 |
| PR | $160.40 | 1 |
| RI | $163.11 | 1 |
| SC | $150.42 | 1 |
| SD | $155.55 | 1 |
| TN | $147.06 | 1 |
| TX | $149.39–$164.91 | 8 |
| UT | $152.39 | 1 |
| VA | $155.85–$181.39 | 2 |
| VI | $160.40 | 1 |
| VT | $155.46 | 1 |
| WA | $164.20–$184.71 | 2 |
| WI | $150.95 | 1 |
| WV | $147.90 | 1 |
| WY | $157.85 | 1 |
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
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 Tennessee 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
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.43 | × 1.000 | 1.4300 |
| Practice expense | 3.17 | × 0.909 | 2.8815 |
| Malpractice | 0.17 | × 0.537 | 0.0913 |
| Total RVUs | 4.4028 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Tennessee$147.06
Office: (1.43 × 1 + 3.17 × 0.909 + 0.17 × 0.537) × $33.4009 = $147.06
Facility: (1.43 × 1 + 1.36 × 0.909 + 0.17 × 0.537) × $33.4009 = $92.10
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
| 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 · 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.
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%).
How 11421 has changed in Tennessee
11421 · Office / nonfacility
$147.06
Effective 2026-10-01
The base rate is $5.40 higher than on 2025-10-01, moving from $141.66 to $147.06 (3.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$141.66changed to$147.06
- 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
- Practice expense GPCI 0.896 changed to 0.909
- Malpractice GPCI 0.544 changed to 0.537
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$146.86changed to$141.66
- 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.
March 9, 2024
RVU24AR
$144.46changed to$146.86
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$148.71changed to$144.46
- 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
- Practice expense GPCI 0.894 changed to 0.896
- Malpractice GPCI 0.518 changed to 0.544
January 1, 2023
RVU23A
$150.38changed to$148.71
- 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
- Practice expense GPCI 0.892 changed to 0.894
- Malpractice GPCI 0.492 changed to 0.518
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$150.53changed to$150.38
- 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.
January 1, 2021
RVU21A
$149.91changed to$150.53
- 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
- Practice expense GPCI 0.897 changed to 0.892
- Malpractice GPCI 0.509 changed to 0.492
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$148.34changed to$149.91
- 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
- Practice expense GPCI 0.901 changed to 0.897
- Malpractice GPCI 0.526 changed to 0.509
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$147.85changed to$148.34
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.81 changed to 2.82
Held through RVU19B, RVU19C, RVU19D.
April 1, 2018
RVU18B
No ratechanged to$147.85
Held through RVU18C, RVU18D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $147.06 | $92.10 | RVU26D |
| 2026-07-01 | $147.06 | $92.10 | RVU26C |
| 2026-04-01 | $147.06 | $92.10 | RVU26B |
| 2026-01-01 | $147.06 | $92.10 | RVU26A |
| 2025-10-01 | $141.66 | $99.06 | RVU25D |
| 2025-07-01 | $141.66 | $99.06 | RVU25C |
| 2025-04-01 | $141.66 | $99.06 | RVU25B |
| 2025-01-01 | $141.66 | $99.06 | RVU25A |
| 2024-10-01 | $146.86 | $101.22 | RVU24D |
| 2024-07-01 | $146.86 | $101.22 | RVU24C |
| 2024-04-01 | $146.86 | $101.22 | RVU24B |
| 2024-03-09 | $146.86 | $101.22 | RVU24AR |
| 2024-01-01 | $144.46 | $99.57 | RVU24A |
| 2023-10-01 | $148.71 | $102.05 | RVU23D |
| 2023-07-01 | $148.71 | $102.05 | RVU23C |
| 2023-04-01 | $148.71 | $102.05 | RVU23B |
| 2023-01-01 | $148.71 | $102.05 | RVU23A |
| 2022-10-01 | $150.38 | $101.92 | RVU22D |
| 2022-07-01 | $150.38 | $101.92 | RVU22C |
| 2022-04-01 | $150.38 | $101.92 | RVU22B |
| 2022-01-01 | $150.38 | $101.92 | RVU22A |
| 2021-10-01 | $150.53 | $101.97 | RVU21D |
| 2021-07-01 | $150.53 | $101.97 | RVU21C |
| 2021-04-01 | $150.53 | $101.97 | RVU21B |
| 2021-01-01 | $150.53 | $101.97 | RVU21A |
| 2020-10-01 | $149.91 | $104.27 | RVU20D |
| 2020-07-01 | $149.91 | $104.27 | RVU20C |
| 2020-04-01 | $149.91 | $104.27 | RVU20B |
| 2020-01-01 | $149.91 | $104.27 | RVU20A |
| 2019-10-01 | $148.34 | $104.83 | RVU19D |
| 2019-07-01 | $148.34 | $104.83 | RVU19C |
| 2019-04-01 | $148.34 | $104.83 | RVU19B |
| 2019-01-01 | $148.34 | $104.83 | RVU19A |
| 2018-10-01 | $147.85 | $104.71 | RVU18D |
| 2018-07-01 | $147.85 | $104.71 | RVU18C |
| 2018-04-01 | $147.85 | $104.71 | RVU18B |
| 2018-01-01 | Rate data unavailable | Rate data unavailable | RVU18AR1 |
| 2017-10-01 | Rate data unavailable | Rate data unavailable | RVU17D |
| 2017-07-01 | Rate data unavailable | Rate data unavailable | RVU17C |
| 2017-04-01 | Rate data unavailable | Rate data unavailable | RVU17B |
| 2017-01-01 | Rate data unavailable | Rate data unavailable | RVU17A |
| 2016-10-01 | Rate data unavailable | Rate data unavailable | RVU16D |
| 2016-07-01 | Rate data unavailable | Rate data unavailable | RVU16C |
| 2016-04-01 | Rate data unavailable | Rate data unavailable | RVU16B |
| 2016-01-01 | Rate data unavailable | Rate data unavailable | RVU16A |
| 2015-10-01 | Rate data unavailable | Rate data unavailable | RVU15D |
| 2015-07-01 | Rate data unavailable | Rate data unavailable | RVU15C |
| 2015-04-01 | Rate data unavailable | Rate data unavailable | RVU15B |
| 2015-01-01 | Rate data unavailable | Rate data unavailable | RVU15A |
| 2014-10-01 | Rate data unavailable | Rate data unavailable | RVU14D |
| 2014-07-01 | Rate data unavailable | Rate data unavailable | RVU14C |
| 2014-04-01 | Rate data unavailable | Rate data unavailable | RVU14B |
| 2014-01-01 | Rate data unavailable | Rate data unavailable | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Tennessee rate applies
Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.
- Adams
- Adamsville
- Alamo
- Alcoa
- Alexandria
- Algood
- Allardt
- Altamont
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
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