CPT code 11426: Benign lesion excision, scalp, neck, hands, feet, genitalia2026 Medicare rate & RVUs in South Dakota

In South Dakota, Medicare pays $325.83 for 11426 in the office and $230.63 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 11426 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 11426 covers

This code is for surgical removal of a benign skin lesion with a total excised diameter greater than 4 cm, including the lesion and its margins. Typical cases include a large benign nevus or cyst on the scalp, hand, or foot. A physician or other qualified practitioner performs the excision in an office, clinic, or surgical setting; the specimen may be sent for pathology.

Choose the code by the anatomic group and the excised diameter, which includes the lesion plus the narrowest margins—not by lesion size alone. Document the site, lesion dimensions, margins, total excised diameter, and diagnosis; record the closure type and length if a separately reportable repair is performed. Simple closure is included, while intermediate or complex repair may be reported separately when supported. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Modifier 50 is inappropriate for this descriptor. Assistant-at-surgery payment is barred, and co-surgeon and team-surgery reporting 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 11426

Across 109 of 109 payment localities, the office rate for 11426 runs from $303.52 in Arkansas to $426.70 in San Benito County, CA. South Dakota pays $325.83. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

11426 rates by state

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

See 11426 in every payment locality

How the 11426 rate is calculated

Each of 11426’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.

Payment rules and modifiers for 11426

11426 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 11426

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

How 11426 has changed in South Dakota

Price 11426 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

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

Open CMS sourceHow we calculate rates