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CPT code 11424: Lesion excision, scalp, neck, hands, feet, genitalia2026 Medicare rate & RVUs in Puerto Rico

Reports excision of a benign skin lesion on the scalp, neck, hands, feet, or genitalia when the excised diameter, including margins, is 3.1 to 4 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality4.8K Medicare services in 2024

In Puerto Rico, Medicare pays $245.30 for 11424 in the office and $165.61 when it’s performed in a hospital or facility.

$245.30Office (non-facility)
$165.61Hospital or facility
+0.6%vs the national office rate ($243.83)

Check a contract rate as a % of Medicare · 11424 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 11424 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 11424 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 11424 covers

This code describes removal of a benign skin lesion from the scalp, neck, hands, feet, or genitalia. A dermatologist, surgeon, or other qualified clinician excises the lesion through the skin, including the margins, in an office or facility setting. The code is selected by both anatomic site and the total excised diameter, not by the lesion’s appearance alone. Simple closure is included; a separately performed intermediate or complex repair may be reported when supported by the repair performed and its documentation.

Document the lesion’s site, benign nature, and excised diameter including margins. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. CMS lists assistant-at-surgery payment as statutorily restricted and does not permit co-surgeon or team-surgery payment.

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 Puerto Rico compares for 11424

Across 109 of 109 payment localities, the office rate for 11424 runs from $216.59 in Arkansas to $313.57 in San Benito County, CA. Puerto Rico pays $245.30. The RVUs are the same everywhere; the geographic indexes change the dollars.

11424 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$245.30
  2. Los Angeles, CA · California$270.55+$25.25
  3. Washington, DC area · District of Columbia$276.40+$31.10
  4. Miami, FL · Florida$268.90+$23.60
  5. Chicago, IL · Illinois$261.15+$15.85
  6. Manhattan, NY · New York$280.65+$35.35
  7. Alaska · Alaska$288.48+$43.18

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

Every other payment area

11424 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$219.63$150.66
ArkansasArkansas$216.59$148.88
ArizonaArizona$237.38$160.99
Bakersfield, CACalifornia$254.99$168.60
Chico, CACalifornia$253.93$167.53
El Centro, CACalifornia$253.99$167.60
Fresno, CACalifornia$253.93$167.53
Hanford, CACalifornia$253.93$167.53

11424 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.

$216.59

$288.48

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

View every state and territory as a table
11424 office rate range by state
State / territoryOffice rate rangeLocalities
AK$288.481
AL$219.631
AR$216.591
AZ$237.381
CA$253.93–$313.5729
CO$251.731
CT$259.641
DC$276.401
DE$241.171
FL$243.41–$268.903
GA$229.93–$248.962
GU$259.261
HI$259.261
IA$223.571
ID$225.261
IL$237.68–$261.154
IN$226.481
KS$223.241
KY$226.061
LA$225.98–$236.622
MA$250.59–$275.002
MD$245.43–$276.403
ME$227.10–$237.912
MI$232.32–$247.032
MN$239.491
MO$222.72–$236.623
MS$219.661
MT$243.801
NC$229.271
ND$236.491
NE$224.541
NH$248.461
NJ$262.12–$273.862
NM$233.811
NV$241.911
NY$232.62–$288.065
OH$230.821
OK$224.951
OR$239.55–$258.682
PA$230.79–$253.842
PR$245.301
RI$249.001
SC$230.521
SD$235.621
TN$224.401
TX$229.39–$251.328
UT$233.531
VA$237.63–$276.402
VI$245.301
VT$236.221
WA$249.91–$279.802
WI$228.951
WV$229.421
WY$240.611

See 11424 in every payment locality

How the 11424 rate is calculated

Each of 11424’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 · 11424

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.42

2.42 RVUs× 1.000 GPCI

Practice expense4.51

4.51 RVUs× 1.000 GPCI

Malpractice0.37

0.37 RVUs× 1.000 GPCI

Adjusted RVUs

7.3000

Conversion factor

$33.4009

Medicare rate

$243.83

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,319

Code
11424
Physician work
2.42
Practice expense
4.51
Malpractice
0.37

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 11424 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.42× 1.0002.4200
Practice expense4.51× 1.0114.5596
Malpractice0.37× 0.9850.3644
Total RVUs7.3441
Conversion factor× 33.4009

Office rate, Puerto Rico$245.30

Office: (2.42 × 1 + 4.51 × 1.011 + 0.37 × 0.985) × $33.4009 = $245.30

Facility: (2.42 × 1 + 2.15 × 1.011 + 0.37 × 0.985) × $33.4009 = $165.61

Open 11424 in the RVU calculator

Payment rules and modifiers for 11424

11424 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11424

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 · 11424

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

11424 without 51 · national office

$243.83

Lesion excision, scalp, neck, hands, feet, genitalia

11424-51 · Second procedure: 50%

$121.92

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 11424

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

Codes related to 11424
CodeHow it relatesOffice range, Puerto Rico
Same family
11423Skin excision, scalp, neck, hands, feet, or genitaliaSame sites and benign excision family, for an excised diameter of 2.1 to 3 cm.$210.08
11426Benign lesion excision, scalp, neck, hands, feet, genitaliaSame sites and benign excision family, for an excised diameter greater than 4 cm.$341.74
Used instead
11404Skin excision, trunk or extremity, 3.1–4 cmBenign excision at trunk or extremity sites for the same 3.1-to-4-cm size range.$232.61
11444Skin excision, face, 3.1–4 cmBenign excision for face, ears, eyelids, nose, lips, or mucous membrane sites in the same size range.$289.90
11624Skin excision, 3.1–4 cm excised diameterMalignant-lesion excision for the same special sites and 3.1-to-4-cm size range.$341.37
Often billed with
12042Intermediate wound repair, neck, hands, feet, or genitaliaMay be reported for a separately performed qualifying intermediate repair on the neck, hands, feet, or genitalia.$307.04

How 11424 has changed in Puerto Rico

11424 · Office / nonfacility

$245.30

Effective 2026-10-01

The base rate is $11.65 higher than on 2025-10-01, moving from $233.65 to $245.30 (5.0%).

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

    $233.65changed to$245.30

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.48 changed to 2.42
    • Practice expense RVU 4.33 changed to 4.51
    • Malpractice RVU 0.39 changed to 0.37
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $239.79changed to$233.65

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.37 changed to 0.39

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $235.88changed to$239.79

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $240.54changed to$235.88

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.24 changed to 4.33
    • Malpractice RVU 0.35 changed to 0.37
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $239.58changed to$240.54

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $242.88changed to$239.58

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.16 changed to 4.24
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $243.48changed to$242.88

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.11 changed to 4.16
    • Malpractice RVU 0.36 changed to 0.35

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $243.12changed to$243.48

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.86 changed to 4.11
    • Malpractice RVU 0.37 changed to 0.36
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $241.91changed to$243.12

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.80 changed to 3.86
    • Malpractice RVU 0.41 changed to 0.37
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $240.92changed to$241.91

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.78 changed to 3.80

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $213.58changed to$240.92

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.74 changed to 3.78
    • Malpractice RVU 0.42 changed to 0.41
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $187.10changed to$213.58

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.72 changed to 3.74
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $187.67changed to$187.10

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.41 changed to 0.42

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $186.74changed to$187.67

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $183.11changed to$186.74

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.65 changed to 3.72
    • Malpractice RVU 0.39 changed to 0.41
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $181.97changed to$183.11

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.08 changed to 3.65
    • Malpractice RVU 0.41 changed to 0.39
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $181.97

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$245.30$165.61RVU26D
2026-07-01$245.30$165.61RVU26C
2026-04-01$245.30$165.61RVU26B
2026-01-01$245.30$165.61RVU26A
2025-10-01$233.65$179.25RVU25D
2025-07-01$233.65$179.25RVU25C
2025-04-01$233.65$179.25RVU25B
2025-01-01$233.65$179.25RVU25A
2024-10-01$239.79$182.14RVU24D
2024-07-01$239.79$182.14RVU24C
2024-04-01$239.79$182.14RVU24B
2024-03-09$239.79$182.14RVU24AR
2024-01-01$235.88$179.16RVU24A
2023-10-01$240.54$180.77RVU23D
2023-07-01$239.58$180.28RVU23C
2023-04-01$239.58$180.28RVU23B
2023-01-01$239.58$180.28RVU23A
2022-10-01$242.88$180.79RVU22D
2022-07-01$242.88$180.79RVU22C
2022-04-01$242.88$180.79RVU22B
2022-01-01$242.88$180.79RVU22A
2021-10-01$243.48$180.52RVU21D
2021-07-01$243.48$180.52RVU21C
2021-04-01$243.48$180.52RVU21B
2021-01-01$243.48$180.52RVU21A
2020-10-01$243.12$184.91RVU20D
2020-07-01$243.12$184.91RVU20C
2020-04-01$243.12$184.91RVU20B
2020-01-01$243.12$184.91RVU20A
2019-10-01$241.91$186.39RVU19D
2019-07-01$241.91$186.39RVU19C
2019-04-01$241.91$186.39RVU19B
2019-01-01$241.91$186.39RVU19A
2018-10-01$240.92$186.18RVU18D
2018-07-01$240.92$186.18RVU18C
2018-04-01$240.92$186.18RVU18B
2018-01-01$240.92$186.18RVU18AR1
2017-10-01$213.58$168.42RVU17D
2017-07-01$213.58$168.42RVU17C
2017-04-01$213.58$168.42RVU17B
2017-01-01$213.58$168.42RVU17A
2016-10-01$187.10$150.00RVU16D
2016-07-01$187.10$150.00RVU16C
2016-04-01$187.10$150.00RVU16B
2016-01-01$187.10$150.00RVU16A
2015-10-01$187.67$150.94RVU15D
2015-07-01$187.67$150.94RVU15C
2015-04-01$186.74$150.19RVU15B
2015-01-01$186.74$150.19RVU15A
2014-10-01$183.11$147.41RVU14D
2014-07-01$183.11$147.41RVU14C
2014-04-01$183.11$147.41RVU14B
2014-01-01$183.11$147.41RVU14A
2013-10-01$181.97$144.60RVU13D
2013-07-01$181.97$144.60RVU13C
2013-04-01$181.97$144.60RVU13B
2013-01-01$181.97$144.60RVU13AR

Price 11424 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

11424 billing questions

How is the 3.1-to-4-cm size determined?

Use the total excised diameter, including the margins, rather than the lesion’s visible diameter alone. Record the measurement and site in the procedure note.

Which sites belong to this code?

Use this code for benign lesions excised from the scalp, neck, hands, feet, or genitalia. Other anatomic sites use their own excision code families.

Is simple closure separately billable?

Simple closure is included in the excision. A separately performed intermediate or complex repair may be reported when its documentation supports separate reporting.

Can modifier 50 be used for lesions on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; report the service according to the applicable lesion and site coding.

What postoperative care is included?

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

How does CMS handle another procedure performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment is statutorily restricted, and co-surgeon and team-surgery payment 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 11424PPRRVU2026_Oct_nonQPP.csv, line 1,319 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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