CPT code 11442: Facial lesion excision, 1.1–2 cm excised diameter2026 Medicare rate & RVUs

Medicare pays $194.06 for 11442 nationally in the office and $131.93 in a hospital or facility. Local office rates run $172.32–$253.99.

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

What 11442 covers

Code 11442 reports surgical removal of a benign skin lesion from the face, ear, eyelid, nose, or lip when the excised diameter, including the lesion and necessary margins, is 1.1–2.0 cm. Common examples include removal of a benign nevus or epidermal inclusion cyst from the cheek or external ear. A physician or other qualified practitioner typically performs the procedure in an office procedure room or outpatient surgical setting. Simple wound closure is included; an intermediate or complex repair may be reported separately when performed and documented.

Select the code using the greatest diameter of the lesion plus the margins needed for complete removal, not the incision length. Document the site, benign diagnosis, measured excised diameter, and procedure performed. CMS assigns 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 at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, 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.

Where 11442 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

11442 rates by state

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

How the 11442 rate is calculated

Each of 11442’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 11442

11442 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

11442 compared with similar codes

How to choose

11441Benign lesion excisionFace, 0.6 to 1 cm

Use 11441 for a facial excised diameter of 0.6–1.0 cm; 11442 begins at 1.1 cm.

11443Skin excisionFace, 2.1 to 3 cm

Use 11443 when the facial excised diameter is 2.1–3.0 cm, rather than 1.1–2.0 cm.

11422Skin lesion excisionScalp, neck, hands, feet, genitalia

The size range is the same, but 11422 applies to scalp, neck, hands, or feet rather than facial sites.

11642Skin lesion excisionFace, ears, eyelids, nose, lips

Use 11642 for excision of a malignant lesion at these sites and in this size range; 11442 is for benign lesions.

Codes related to 11442

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

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