Billing code 11451: Axillary hidradenitis excisionMedicare rate & RVUs

Medicare pays $574.16 for 11451 nationally in the office and $319.98 in a hospital or facility. Local office rates run $502.06–$749.77.

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

What 11451 covers

This code is for surgical removal of skin and underlying subcutaneous tissue affected by hidradenitis in the axilla, with complex repair of the resulting wound. Dermatologic, general, or plastic surgeons may perform the procedure, commonly in a facility setting for more extensive disease. The code is specific to the axilla; disease at other sites uses the corresponding hidradenitis excision code for that location.

Choose this code when the axillary excision is accompanied by complex repair, rather than simple or intermediate repair. Document the operative site and laterality, excision performed, and repair details supporting the complex level. The repair is included in this service and should not be separately unbundled. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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 11451 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

11451 rates by state

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

How the 11451 rate is calculated

Each of 11451’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 11451

11451 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

11451 compared with similar codes

How to choose

11450Hidradenitis excision

Both are for axillary hidradenitis excision. The repair level distinguishes them: 11450 covers simple or intermediate repair, while 11451 covers complex repair.

11463Hidradenitis excision

This code covers complex repair after hidradenitis excision in the inguinal region, not the axilla.

11471Hidradenitis excision

This code covers complex repair after hidradenitis excision at perianal, perineal, or umbilical sites, rather than the axilla.

Codes related to 11451

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