Billing code 11402: Skin lesion excisionMedicare rate & RVUs

Medicare pays $171.01 for 11402 nationally in the office and $102.54 in a hospital or facility. Local office rates run $151.47–$225.52.

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

What 11402 covers

This service removes a benign skin lesion from the trunk, an arm, or a leg, including the margins taken around it. Typical examples include an epidermal inclusion cyst or benign nevus removed in a physician office or outpatient setting. The code is specific to these body regions; lesions on the head, neck, hands, feet, or genitalia fall into different anatomic code families.

Select the size by adding the lesion’s greatest clinical diameter to the narrowest margins required for complete removal; the resulting excised diameter must be 1.1–2 cm. Document the site, benign lesion, and dimensions supporting that measurement. Simple closure is part of the excision; a separately qualifying intermediate or complex repair may be reported. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. The bilateral adjustment is unavailable, 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 11402 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

11402 rates by state

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

How the 11402 rate is calculated

Each of 11402’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 11402

11402 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

11402 compared with similar codes

How to choose

11401Benign lesion excision

Both codes cover benign lesions on the trunk, arms, or legs. Choose 11401 when the lesion plus required margins measures 0.6–1 cm rather than 1.1–2 cm.

11403Benign lesion excision

This is the next larger size level for benign lesions on the same body regions: the lesion plus margins measures 2.1–3 cm.

11422Skin lesion excision

The size range is the same, but 11422 is for lesions on the head, neck, hands, feet, or genitalia rather than the trunk, arms, or legs.

11602Malignant lesion excision

This code is for a malignant lesion on the trunk, arms, or legs in the same size range. Code 11402 is for a benign lesion.

Codes related to 11402

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