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CPT code 11423: Skin excision, scalp, neck, hands, feet, or genitalia2026 Medicare rate & RVUs in Hawaii, Guam, HI

Removal of a benign skin lesion from the scalp, neck, hands, feet, or genitalia when its excised diameter, including margins, is 2.1 to 3.0 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality14.1K Medicare services in 2024

In Hawaii, Guam, HI, Medicare pays $223.13 for 11423 in the office and $149.07 when it’s performed in a hospital or facility.

$223.13Office (non-facility)
$149.07Hospital or facility
+6.9%vs the national office rate ($208.76)

Check a contract rate as a % of Medicare · 11423 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 11423 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Hawaii, Guam, HI
  2. What 11423 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 11423 covers

This service removes a clinically benign skin lesion from the scalp, neck, hand, foot, or genital area, with the surrounding margin included in the excision. Dermatologists, surgeons, and other qualified clinicians commonly perform it in an office or outpatient setting. The code is selected by both the anatomic group and the excised diameter, measured across the lesion and margins; a 2.1-to-3.0 cm measurement falls in this size level.

The operative note should identify the site, lesion, and excised diameter, including margins. A simple closure is included in the excision; a separately reportable more extensive repair may be coded when supported. This is a minor procedure with a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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 Hawaii, Guam, HI compares for 11423

Across 109 of 109 payment localities, the office rate for 11423 runs from $185.68 in Arkansas to $270.57 in San Benito County, CA. Hawaii, Guam, HI pays $223.13. The RVUs are the same everywhere; the geographic indexes change the dollars.

11423 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$223.13
  2. Los Angeles, CA · California$232.74+$9.61
  3. Washington, DC area · District of Columbia$237.00+$13.87
  4. Miami, FL · Florida$227.98+$4.85
  5. Chicago, IL · Illinois$221.57−$1.56
  6. Manhattan, NY · New York$239.82+$16.69
  7. Alaska · Alaska$246.89+$23.76

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

Every other payment area

11423 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$188.27$131.28
ArkansasArkansas$185.68$129.74
ArizonaArizona$203.35$140.23
Bakersfield, CACalifornia$219.23$147.85
Chico, CACalifornia$218.44$147.06
El Centro, CACalifornia$218.49$147.10
Fresno, CACalifornia$218.44$147.06
Hanford, CACalifornia$218.44$147.06

11423 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.

$185.68

$246.89

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

View every state and territory as a table
11423 office rate range by state
State / territoryOffice rate rangeLocalities
AK$246.891
AL$188.271
AR$185.681
AZ$203.351
CA$218.44–$270.5729
CO$216.071
CT$222.201
DC$237.001
DE$206.591
FL$207.46–$227.983
GA$196.17–$212.892
GU$223.131
HI$223.131
IA$192.051
ID$193.391
IL$202.30–$221.574
IN$194.441
KS$191.551
KY$193.271
LA$193.13–$202.162
MA$215.03–$236.242
MD$210.28–$237.003
ME$194.74–$204.232
MI$198.38–$210.302
MN$206.251
MO$190.22–$202.413
MS$187.971
MT$208.741
NC$196.621
ND$203.401
NE$192.941
NH$213.071
NJ$224.52–$234.812
NM$199.561
NV$207.381
NY$199.45–$245.845
OH$197.291
OK$192.561
OR$205.55–$222.242
PA$197.39–$217.142
PR$210.081
RI$213.431
SC$197.331
SD$202.771
TN$192.511
TX$196.18–$215.558
UT$199.881
VA$203.85–$237.002
VI$210.081
VT$202.971
WA$214.50–$240.562
WI$196.951
WV$195.271
WY$206.411

See 11423 in every payment locality

How the 11423 rate is calculated

Each of 11423’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 · 11423

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.01

2.01 RVUs× 1.000 GPCI

Practice expense3.97

3.97 RVUs× 1.000 GPCI

Malpractice0.27

0.27 RVUs× 1.000 GPCI

Adjusted RVUs

6.2500

Conversion factor

$33.4009

Medicare rate

$208.76

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

The exact Hawaii, Guam, HI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,318

Code
11423
Physician work
2.01
Practice expense
3.97
Malpractice
0.27

GPCI2026.csv

46

Locality
Hawaii, Guam, HI
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Office calculation for 11423 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work2.01× 1.0002.0100
Practice expense3.97× 1.1374.5139
Malpractice0.27× 0.5790.1563
Total RVUs6.6802
Conversion factor× 33.4009

Office rate, Hawaii, Guam, HI$223.13

Office: (2.01 × 1 + 3.97 × 1.137 + 0.27 × 0.579) × $33.4009 = $223.13

Facility: (2.01 × 1 + 2.02 × 1.137 + 0.27 × 0.579) × $33.4009 = $149.07

Open 11423 in the RVU calculator

Payment rules and modifiers for 11423

11423 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11423

Skin excision, scalp, neck, hands, feet, or 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 · 11423

Skin excision, scalp, neck, hands, feet, or 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

11423 without 51 · national office

$208.76

Skin excision, scalp, neck, hands, feet, or genitalia

11423-51 · Second procedure: 50%

$104.38

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 11423

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

Codes related to 11423
CodeHow it relatesOffice range, Hawaii, Guam, HI
Same family
11422Skin lesion excision, scalp, neck, hands, feet, genitaliaSame anatomic group, for an excised diameter of 1.1 to 2.0 cm.$192.90
11424Lesion excision, scalp, neck, hands, feet, genitaliaSame anatomic group, for an excised diameter of 3.1 to 4.0 cm.$259.26
Used instead
11403Benign lesion excision, trunk or limb, 2.1–3 cmSame size level for benign lesions on the trunk or extremities.$214.25
11443Skin excision, face, 2.1 to 3 cmSame size level for benign lesions of the face or mucous membrane.$245.64
11623Skin excision, scalp, neck, hand, foot, genital skinMalignant-lesion excision in the same anatomic group and size range.$314.77

How 11423 has changed in Hawaii, Guam, HI

11423 · Office / nonfacility

$223.13

Effective 2026-10-01

The base rate is $7.58 higher than on 2025-10-01, moving from $215.55 to $223.13 (3.5%).

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

    $215.55changed to$223.13

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.06 changed to 2.01
    • Practice expense RVU 3.87 changed to 3.97
    • Malpractice RVU 0.28 changed to 0.27
    • Practice expense GPCI 1.149 changed to 1.137
    • Malpractice GPCI 0.561 changed to 0.579

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $221.63changed to$215.55

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $218.01changed to$221.63

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $223.63changed to$218.01

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.81 changed to 3.87
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 1.146 changed to 1.149
    • Malpractice GPCI 0.618 changed to 0.561

  5. January 1, 2023

    RVU23A

    $227.43changed to$223.63

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.77 changed to 3.81
    • Work GPCI 1.010 changed to 1.003
    • Practice expense GPCI 1.143 changed to 1.146
    • Malpractice GPCI 0.675 changed to 0.618

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $227.72changed to$227.43

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.73 changed to 3.77

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $224.56changed to$227.72

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.47 changed to 3.73
    • Malpractice RVU 0.28 changed to 0.27
    • Work GPCI 1.006 changed to 1.010
    • Practice expense GPCI 1.144 changed to 1.143
    • Malpractice GPCI 0.644 changed to 0.675

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $221.41changed to$224.56

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.39 changed to 3.47
    • Malpractice RVU 0.32 changed to 0.28
    • Work GPCI 1.001 changed to 1.006
    • Practice expense GPCI 1.146 changed to 1.144
    • Malpractice GPCI 0.614 changed to 0.644

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $219.93changed to$221.41

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.36 changed to 3.39

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $219.29changed to$219.93

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.33 changed to 3.36
    • Malpractice RVU 0.33 changed to 0.32
    • Work GPCI 1.002 changed to 1.001
    • Practice expense GPCI 1.154 changed to 1.146
    • Malpractice GPCI 0.616 changed to 0.614

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $219.82changed to$219.29

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.003 changed to 1.002
    • Practice expense GPCI 1.162 changed to 1.154
    • Malpractice GPCI 0.618 changed to 0.616

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $220.81changed to$219.82

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.34 changed to 3.33
    • Malpractice RVU 0.32 changed to 0.33

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $219.71changed to$220.81

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $217.15changed to$219.71

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.27 changed to 3.34
    • Work GPCI 1.002 changed to 1.003
    • Practice expense GPCI 1.158 changed to 1.162
    • Malpractice GPCI 0.659 changed to 0.618

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $222.43changed to$217.15

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.68 changed to 3.27
    • Malpractice RVU 0.33 changed to 0.32
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.700 changed to 0.659

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$222.43

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$223.13$149.07RVU26D
2026-07-01$223.13$149.07RVU26C
2026-04-01$223.13$149.07RVU26B
2026-01-01$223.13$149.07RVU26A
2025-10-01$215.55$163.52RVU25D
2025-07-01$215.55$163.52RVU25C
2025-04-01$215.55$163.52RVU25B
2025-01-01$215.55$163.52RVU25A
2024-10-01$221.63$165.79RVU24D
2024-07-01$221.63$165.79RVU24C
2024-04-01$221.63$165.79RVU24B
2024-03-09$221.63$165.79RVU24AR
2024-01-01$218.01$163.08RVU24A
2023-10-01$223.63$166.16RVU23D
2023-07-01$223.63$166.16RVU23C
2023-04-01$223.63$166.16RVU23B
2023-01-01$223.63$166.16RVU23A
2022-10-01$227.43$166.52RVU22D
2022-07-01$227.43$166.52RVU22C
2022-04-01$227.43$166.52RVU22B
2022-01-01$227.43$166.52RVU22A
2021-10-01$227.72$166.30RVU21D
2021-07-01$227.72$166.30RVU21C
2021-04-01$227.72$166.30RVU21B
2021-01-01$227.72$166.30RVU21A
2020-10-01$224.56$168.41RVU20D
2020-07-01$224.56$168.41RVU20C
2020-04-01$224.56$168.41RVU20B
2020-01-01$224.56$168.41RVU20A
2019-10-01$221.41$168.13RVU19D
2019-07-01$221.41$168.13RVU19C
2019-04-01$221.41$168.13RVU19B
2019-01-01$221.41$168.13RVU19A
2018-10-01$219.93$168.36RVU18D
2018-07-01$219.93$168.36RVU18C
2018-04-01$219.93$168.36RVU18B
2018-01-01$219.93$168.36RVU18AR1
2017-10-01$219.29$168.76RVU17D
2017-07-01$219.29$168.76RVU17C
2017-04-01$219.29$168.76RVU17B
2017-01-01$219.29$168.76RVU17A
2016-10-01$219.82$169.07RVU16D
2016-07-01$219.82$169.07RVU16C
2016-04-01$219.82$169.07RVU16B
2016-01-01$219.82$169.07RVU16A
2015-10-01$220.81$170.29RVU15D
2015-07-01$220.81$170.29RVU15C
2015-04-01$219.71$169.44RVU15B
2015-01-01$219.71$169.44RVU15A
2014-10-01$217.15$167.37RVU14D
2014-07-01$217.15$167.37RVU14C
2014-04-01$217.15$167.37RVU14B
2014-01-01$217.15$167.37RVU14A
2013-10-01$222.43$169.04RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 11423 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

  • Ahuimanu
  • Aiea
  • Ainaloa
  • Anahola
  • Black Sands
  • Captain Cook
  • Discovery Harbour
  • East Honolulu

Browse all communities in Hawaii

11423 billing questions

How is the 2.1-to-3.0 cm size determined?

Use the excised diameter, including the lesion and margins, rather than the lesion alone. Document the measurement and the anatomic site.

Which nearby code applies when the lesion is on the trunk or an extremity?

For a benign lesion on the trunk or an extremity, use the corresponding 11400-series code based on excised diameter. Code 11403 covers that anatomic group at the 2.1-to-3.0 cm level.

Can the repair be billed separately?

Simple closure is included. A more extensive repair may be separately reported when its complexity and documentation meet the requirements for a repair code.

Can modifier 50 be used for lesions on both sides?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Are postoperative visits included?

Related postoperative visits during the 10-day global period are included in the procedure payment.

Can an assistant surgeon or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing 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
RVUs for 11423PPRRVU2026_Oct_nonQPP.csv, line 1,318 (RVU26D)
Geographic factors for Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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