Billing code 11420: Benign lesion excisionMedicare rate & RVUs

Medicare pays $124.92 for 11420 nationally in the office and $76.15 in a hospital or facility. Local office rates run $110.75–$165.72.

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

What 11420 covers

This code covers surgical removal of a small benign skin lesion from the scalp, neck, a hand, a foot, or the genitalia. Dermatologists, primary care clinicians, and surgeons may perform the procedure in an office or facility. The coded size is the greatest diameter of the lesion plus the margins removed, not the lesion alone. A suspected nevus or cyst may be removed for treatment or diagnosis; the record should identify the site and document the excised diameter and benign clinical assessment.

Choose this code only when the site falls within this group and the excised diameter is 0.5 cm or less. Use the appropriate sibling code when the diameter is larger, or a different site-specific code for another body region. The 10-day global period includes related postoperative visits during that period. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; 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 11420 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

11420 rates by state

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

How the 11420 rate is calculated

Each of 11420’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 11420

11420 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

11420 compared with similar codes

How to choose

11421Lesion excision

The site group is the same, but 11421 applies when the excised diameter is 0.6 to 1.0 cm; 11420 is for 0.5 cm or less.

11400Skin lesion excision

Both report excision of a small benign lesion, but 11400 is for trunk or extremity sites outside the scalp, neck, hands, feet, and genitalia group.

11440Lesion excision

Use 11440 for benign lesion excision on the face, ears, eyelids, nose, or lips, not the site group covered by 11420.

11200Skin tag removal

Use 11200 for skin-tag removal. Code 11420 is for excision of a benign lesion at a specified site, with size measured including margins.

Codes related to 11420

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