Billing code 11406: Skin lesion excisionMedicare rate & RVUs

Medicare pays $333.67 for 11406 nationally in the office and $227.79 in a hospital or facility. Local office rates run $295.43–$423.76.

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

What 11406 covers

This service removes a benign skin lesion from the trunk, arm, or leg, with a margin of surrounding tissue. The code is selected when the excised diameter—the lesion’s greatest diameter plus the margins—is greater than 4.0 cm. Dermatologists, surgeons, and other clinicians who perform skin procedures may report it in an office or facility setting. It is not the site-specific code for lesions on the scalp, neck, hands, feet, or face.

Document the lesion’s location, benign diagnosis, size, margins, and total excised diameter. Simple wound closure is included; a separately reportable repair may be appropriate when a more complex closure is performed. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, 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 11406 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

11406 rates by state

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

How the 11406 rate is calculated

Each of 11406’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 11406

11406 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

11406 compared with similar codes

How to choose

11404Skin excision

Both cover benign lesion excision on the trunk, arms, or legs. Choose 11404 when the lesion plus margins measures 3.1–4.0 cm; choose 11406 when it exceeds 4.0 cm.

11426Benign lesion excision

This code is for the scalp, neck, hands, or feet site group when the excised diameter exceeds 4.0 cm. Use 11406 for the trunk, arms, or legs at that size.

11446Skin lesion excision

This code covers benign lesion excision over 4.0 cm on the face. Use 11406 for the trunk, arms, or legs.

Codes related to 11406

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