CPT code 11423: Skin excision, scalp, neck, hands, feet, or genitalia2026 Medicare rate & RVUs in Rhode Island
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.
In Rhode Island, Medicare pays $213.43 for 11423 in the office and $146.15 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Rhode Island 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. Rhode Island pays $213.43. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Rhode Island · this page$213.43
- Los Angeles, CA · California$232.74+$19.31
- Washington, DC area · District of Columbia$237.00+$23.57
- Miami, FL · Florida$227.98+$14.55
- Chicago, IL · Illinois$221.57+$8.14
- Manhattan, NY · New York$239.82+$26.39
- Alaska · Alaska$246.89+$33.46
Other areas in Rhode Island first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $218.44 | $147.06 |
| Merced, CACalifornia | $218.44 | $147.06 |
| Modesto, CACalifornia | $218.44 | $147.06 |
| Napa, CACalifornia | $250.72 | $164.87 |
| Oxnard, CACalifornia | $231.37 | $154.38 |
| Redding, CACalifornia | $218.44 | $147.06 |
| Rest of CaliforniaCalifornia | $218.44 | $147.06 |
| Riverside, CACalifornia | $221.37 | $149.98 |
| Sacramento, CACalifornia | $228.60 | $152.85 |
| Salinas, CACalifornia | $227.74 | $152.25 |
| San Diego, CACalifornia | $232.63 | $154.73 |
| Marin County, CACalifornia | $264.62 | $172.79 |
| San Francisco, CACalifornia | $264.31 | $172.48 |
| San Benito County, CACalifornia | $270.57 | $176.65 |
| Santa Clara County, CACalifornia | $269.31 | $175.39 |
| San Luis Obispo, CACalifornia | $224.14 | $149.96 |
| Santa Cruz, CACalifornia | $234.49 | $155.36 |
| Santa Maria, CACalifornia | $228.46 | $152.52 |
| Santa Rosa, CACalifornia | $236.82 | $156.84 |
| Stockton, CACalifornia | $218.44 | $147.06 |
| Vallejo, CACalifornia | $250.27 | $164.43 |
| Visalia, CACalifornia | $218.44 | $147.06 |
| Yuba City, CACalifornia | $218.44 | $147.06 |
| ColoradoColorado | $216.07 | $146.77 |
| ConnecticutConnecticut | $222.20 | $152.06 |
| DelawareDelaware | $206.59 | $142.24 |
| Fort Lauderdale, FLFlorida | $217.77 | $151.79 |
| Rest of FloridaFlorida | $207.46 | $145.19 |
| Atlanta, GAGeorgia | $212.89 | $146.72 |
| Rest of GeorgiaGeorgia | $196.17 | $138.07 |
| Hawaii, Guam, HIHawaii | $223.13 | $149.07 |
| IowaIowa | $192.05 | $132.45 |
| IdahoIdaho | $193.39 | $133.47 |
| East St. Louis, ILIllinois | $207.29 | $147.37 |
| Rest of IllinoisIllinois | $202.30 | $142.83 |
| Suburban Chicago, ILIllinois | $219.77 | $152.88 |
| IndianaIndiana | $194.44 | $134.06 |
| KansasKansas | $191.55 | $132.67 |
| KentuckyKentucky | $193.27 | $135.37 |
| New Orleans, LALouisiana | $202.16 | $140.87 |
| Rest of LouisianaLouisiana | $193.13 | $135.49 |
| Metropolitan Boston, MAMassachusetts | $236.24 | $158.47 |
| Rest of MassachusettsMassachusetts | $215.03 | $146.44 |
| Baltimore area, MDMaryland | $221.65 | $151.76 |
| Rest of MarylandMaryland | $210.28 | $144.37 |
| Rest of MaineMaine | $194.74 | $134.82 |
| Southern Maine, MEMaine | $204.23 | $139.69 |
| Detroit, MIMichigan | $210.30 | $147.45 |
| Rest of MichiganMichigan | $198.38 | $138.92 |
| MinnesotaMinnesota | $206.25 | $139.23 |
| Metropolitan Kansas City, MOMissouri | $200.46 | $139.30 |
| Metropolitan St. Louis, MOMissouri | $202.41 | $140.40 |
| Rest of MissouriMissouri | $190.22 | $134.08 |
| MississippiMississippi | $187.97 | $131.89 |
| MontanaMontana | $208.74 | $143.61 |
| North CarolinaNorth Carolina | $196.62 | $135.85 |
| North DakotaNorth Dakota | $203.40 | $138.27 |
| NebraskaNebraska | $192.94 | $132.82 |
| New HampshireNew Hampshire | $213.07 | $145.26 |
| Northern New JerseyNew Jersey | $234.81 | $159.26 |
| Rest of New JerseyNew Jersey | $224.52 | $153.39 |
| New MexicoNew Mexico | $199.56 | $139.84 |
| NevadaNevada | $207.38 | $142.19 |
| NYC suburbs and Long Island, NYNew York | $245.84 | $168.40 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $226.27 | $154.95 |
| Queens, NYNew York | $241.17 | $164.19 |
| Rest of New YorkNew York | $199.45 | $137.57 |
| OhioOhio | $197.29 | $137.83 |
| OklahomaOklahoma | $192.56 | $134.39 |
| Portland, OROregon | $222.24 | $149.88 |
| Rest of OregonOregon | $205.55 | $140.68 |
| Metropolitan Philadelphia, PAPennsylvania | $217.14 | $149.34 |
| Rest of PennsylvaniaPennsylvania | $197.39 | $137.60 |
| Puerto RicoPuerto Rico | $210.08 | $144.23 |
| South CarolinaSouth Carolina | $197.33 | $137.14 |
| South DakotaSouth Dakota | $202.77 | $137.64 |
| TennesseeTennessee | $192.51 | $133.31 |
| Austin, TXTexas | $215.55 | $146.64 |
| Beaumont, TXTexas | $196.18 | $136.91 |
| Brazoria, TXTexas | $206.12 | $141.57 |
| Dallas, TXTexas | $207.55 | $142.68 |
| Fort Worth, TXTexas | $206.34 | $142.12 |
| Galveston, TXTexas | $206.81 | $142.14 |
| Houston, TXTexas | $211.76 | $147.08 |
| Rest of TexasTexas | $201.12 | $139.31 |
| UtahUtah | $199.88 | $138.66 |
| VirginiaVirginia | $203.85 | $139.83 |
| Virgin Islands, VIUnited States Virgin Islands | $210.08 | $144.23 |
| VermontVermont | $202.97 | $138.49 |
| Rest of WashingtonWashington | $214.50 | $145.92 |
| King County, WAWashington | $240.56 | $160.65 |
| WisconsinWisconsin | $196.95 | $134.55 |
| West VirginiaWest Virginia | $195.27 | $138.67 |
| WyomingWyoming | $206.41 | $141.28 |
11423 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.
$185.68
$246.89
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 | $246.89 | 1 |
| AL | $188.27 | 1 |
| AR | $185.68 | 1 |
| AZ | $203.35 | 1 |
| CA | $218.44–$270.57 | 29 |
| CO | $216.07 | 1 |
| CT | $222.20 | 1 |
| DC | $237.00 | 1 |
| DE | $206.59 | 1 |
| FL | $207.46–$227.98 | 3 |
| GA | $196.17–$212.89 | 2 |
| GU | $223.13 | 1 |
| HI | $223.13 | 1 |
| IA | $192.05 | 1 |
| ID | $193.39 | 1 |
| IL | $202.30–$221.57 | 4 |
| IN | $194.44 | 1 |
| KS | $191.55 | 1 |
| KY | $193.27 | 1 |
| LA | $193.13–$202.16 | 2 |
| MA | $215.03–$236.24 | 2 |
| MD | $210.28–$237.00 | 3 |
| ME | $194.74–$204.23 | 2 |
| MI | $198.38–$210.30 | 2 |
| MN | $206.25 | 1 |
| MO | $190.22–$202.41 | 3 |
| MS | $187.97 | 1 |
| MT | $208.74 | 1 |
| NC | $196.62 | 1 |
| ND | $203.40 | 1 |
| NE | $192.94 | 1 |
| NH | $213.07 | 1 |
| NJ | $224.52–$234.81 | 2 |
| NM | $199.56 | 1 |
| NV | $207.38 | 1 |
| NY | $199.45–$245.84 | 5 |
| OH | $197.29 | 1 |
| OK | $192.56 | 1 |
| OR | $205.55–$222.24 | 2 |
| PA | $197.39–$217.14 | 2 |
| PR | $210.08 | 1 |
| RI | $213.43 | 1 |
| SC | $197.33 | 1 |
| SD | $202.77 | 1 |
| TN | $192.51 | 1 |
| TX | $196.18–$215.55 | 8 |
| UT | $199.88 | 1 |
| VA | $203.85–$237.00 | 2 |
| VI | $210.08 | 1 |
| VT | $202.97 | 1 |
| WA | $214.50–$240.56 | 2 |
| WI | $196.95 | 1 |
| WV | $195.27 | 1 |
| WY | $206.41 | 1 |
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
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 Rhode Island 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
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.01 | × 1.019 | 2.0482 |
| Practice expense | 3.97 | × 1.033 | 4.1010 |
| Malpractice | 0.27 | × 0.892 | 0.2408 |
| Total RVUs | 6.3900 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Rhode Island$213.43
Office: (2.01 × 1.019 + 3.97 × 1.033 + 0.27 × 0.892) × $33.4009 = $213.43
Facility: (2.01 × 1.019 + 2.02 × 1.033 + 0.27 × 0.892) × $33.4009 = $146.15
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
| 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 · 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.
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%).
How 11423 has changed in Rhode Island
11423 · Office / nonfacility
$213.43
Effective 2026-10-01
The base rate is $7.38 higher than on 2025-10-01, moving from $206.05 to $213.43 (3.6%).
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
$206.05changed to$213.43
- 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
- Work GPCI 1.025 changed to 1.019
- Practice expense GPCI 1.039 changed to 1.033
- Malpractice GPCI 0.849 changed to 0.892
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$211.76changed to$206.05
- Conversion factor 33.2875 changed to 32.3465
- Malpractice RVU 0.27 changed to 0.28
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$208.31changed to$211.76
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$214.58changed to$208.31
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.81 changed to 3.87
- Work GPCI 1.023 changed to 1.025
- Practice expense GPCI 1.044 changed to 1.039
- Malpractice GPCI 0.915 changed to 0.849
January 1, 2023
RVU23A
$218.68changed to$214.58
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.77 changed to 3.81
- Work GPCI 1.021 changed to 1.023
- Practice expense GPCI 1.048 changed to 1.044
- Malpractice GPCI 0.981 changed to 0.915
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$219.03changed to$218.68
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.73 changed to 3.77
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$217.50changed to$219.03
- 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 1.024 changed to 1.021
- Practice expense GPCI 1.049 changed to 1.048
- Malpractice GPCI 0.990 changed to 0.981
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$216.05changed to$217.50
- 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 1.027 changed to 1.024
- Practice expense GPCI 1.050 changed to 1.049
- Malpractice GPCI 0.999 changed to 0.990
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$214.68changed to$216.05
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.36 changed to 3.39
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$211.91changed to$214.68
- 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 1.025 changed to 1.027
- Practice expense GPCI 1.052 changed to 1.050
- Malpractice GPCI 0.879 changed to 0.999
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$209.89changed to$211.91
- Conversion factor 35.8043 changed to 35.8887
- Work GPCI 1.022 changed to 1.025
- Practice expense GPCI 1.053 changed to 1.052
- Malpractice GPCI 0.759 changed to 0.879
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$210.76changed to$209.89
- 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.
July 1, 2015
RVU15C
$209.71changed to$210.76
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$209.77changed to$209.71
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 3.27 changed to 3.34
- Work GPCI 1.020 changed to 1.022
- Malpractice GPCI 0.973 changed to 0.759
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$209.77
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $213.43 | $146.15 | RVU26D |
| 2026-07-01 | $213.43 | $146.15 | RVU26C |
| 2026-04-01 | $213.43 | $146.15 | RVU26B |
| 2026-01-01 | $213.43 | $146.15 | RVU26A |
| 2025-10-01 | $206.05 | $159.00 | RVU25D |
| 2025-07-01 | $206.05 | $159.00 | RVU25C |
| 2025-04-01 | $206.05 | $159.00 | RVU25B |
| 2025-01-01 | $206.05 | $159.00 | RVU25A |
| 2024-10-01 | $211.76 | $161.27 | RVU24D |
| 2024-07-01 | $211.76 | $161.27 | RVU24C |
| 2024-04-01 | $211.76 | $161.27 | RVU24B |
| 2024-03-09 | $211.76 | $161.27 | RVU24AR |
| 2024-01-01 | $208.31 | $158.64 | RVU24A |
| 2023-10-01 | $214.58 | $162.22 | RVU23D |
| 2023-07-01 | $214.58 | $162.22 | RVU23C |
| 2023-04-01 | $214.58 | $162.22 | RVU23B |
| 2023-01-01 | $214.58 | $162.22 | RVU23A |
| 2022-10-01 | $218.68 | $162.83 | RVU22D |
| 2022-07-01 | $218.68 | $162.83 | RVU22C |
| 2022-04-01 | $218.68 | $162.83 | RVU22B |
| 2022-01-01 | $218.68 | $162.83 | RVU22A |
| 2021-10-01 | $219.03 | $162.72 | RVU21D |
| 2021-07-01 | $219.03 | $162.72 | RVU21C |
| 2021-04-01 | $219.03 | $162.72 | RVU21B |
| 2021-01-01 | $219.03 | $162.72 | RVU21A |
| 2020-10-01 | $217.50 | $166.01 | RVU20D |
| 2020-07-01 | $217.50 | $166.01 | RVU20C |
| 2020-04-01 | $217.50 | $166.01 | RVU20B |
| 2020-01-01 | $217.50 | $166.01 | RVU20A |
| 2019-10-01 | $216.05 | $167.23 | RVU19D |
| 2019-07-01 | $216.05 | $167.23 | RVU19C |
| 2019-04-01 | $216.05 | $167.23 | RVU19B |
| 2019-01-01 | $216.05 | $167.23 | RVU19A |
| 2018-10-01 | $214.68 | $167.43 | RVU18D |
| 2018-07-01 | $214.68 | $167.43 | RVU18C |
| 2018-04-01 | $214.68 | $167.43 | RVU18B |
| 2018-01-01 | $214.68 | $167.43 | RVU18AR1 |
| 2017-10-01 | $211.91 | $165.85 | RVU17D |
| 2017-07-01 | $211.91 | $165.85 | RVU17C |
| 2017-04-01 | $211.91 | $165.85 | RVU17B |
| 2017-01-01 | $211.91 | $165.85 | RVU17A |
| 2016-10-01 | $209.89 | $163.90 | RVU16D |
| 2016-07-01 | $209.89 | $163.90 | RVU16C |
| 2016-04-01 | $209.89 | $163.90 | RVU16B |
| 2016-01-01 | $209.89 | $163.90 | RVU16A |
| 2015-10-01 | $210.76 | $164.97 | RVU15D |
| 2015-07-01 | $210.76 | $164.97 | RVU15C |
| 2015-04-01 | $209.71 | $164.15 | RVU15B |
| 2015-01-01 | $209.71 | $164.15 | RVU15A |
| 2014-10-01 | $209.77 | $164.51 | RVU14D |
| 2014-07-01 | $209.77 | $164.51 | RVU14C |
| 2014-04-01 | $209.77 | $164.51 | RVU14B |
| 2014-01-01 | $209.77 | $164.51 | 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 Rhode Island rate applies
Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.
- Ashaway
- Bradford
- Carolina
- Central Falls
- Charlestown
- Chepachet
- Clayville
- Cranston
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
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