Billing code 11423: Skin excisionMedicare rate & RVUs

Medicare pays $208.76 for 11423 nationally in the office and $143.62 in a hospital or facility. Local office rates run $185.68–$270.57.

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

What 11423 covers

This service removes a clinically benign skin lesion from the scalp, neck, hand, foot, or genital area, with the surrounding margin included in the excision. Dermatologists, surgeons, and other qualified clinicians commonly perform it in an office or outpatient setting. The code is selected by both the anatomic group and the excised diameter, measured across the lesion and margins; a 2.1-to-3.0 cm measurement falls in this size level.

The operative note should identify the site, lesion, and excised diameter, including margins. A simple closure is included in the excision; a separately reportable more extensive repair may be coded when supported. This is a minor procedure with 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 are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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 11423 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

11423 rates by state

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

How the 11423 rate is calculated

Each of 11423’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 11423

11423 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

11423 compared with similar codes

How to choose

11403Benign lesion excision

Use 11403 for the same excised diameter when the benign lesion is on the trunk or an extremity. This code is for the scalp, neck, hands, feet, or genitalia.

11422Skin lesion excision

This code is for an excised diameter of 2.1 to 3.0 cm; 11422 is the same anatomic group but covers 1.1 to 2.0 cm.

11443Skin excision

Both cover benign lesions at the 2.1-to-3.0 cm size level, but 11443 is for the face or mucous membrane rather than this code’s anatomic group.

11623Skin excision

Use 11623 for a malignant lesion in this anatomic group and size range. This code is for a benign lesion.

Codes related to 11423

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