Billing code 11462: Hidradenitis excisionMedicare rate & RVUs
Excision of hidradenitis-affected skin and subcutaneous tissue in the inguinal region, closed with a simple or intermediate repair.
Medicare pays $449.58 for 11462 nationally in the office and $242.82 in a hospital or facility. Local office rates run $392.63–$596.43.
Medicare rate · 11462
Hidradenitis excision
- Work RVUs
- 2.93
- Total RVUs
- 13.46
- Global days
- 090
National rate · 2026
$449.58
Office setting, before claim adjustments.
See every locality for 11462 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 11462 covers
This service removes hidradenitis-affected skin and underlying tissue from the groin, including involved areas in the inguinal folds. It is performed by a surgeon or dermatologic surgeon to treat chronic disease with recurrent nodules or sinus tracts. The excision may be done in an office or an outpatient surgical setting, depending on its extent and the planned closure.
Report this code for inguinal excision when the wound receives a simple or intermediate repair; complex repair is represented by 11463. Document the diagnosis, inguinal site, excision performed, and repair level. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure 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 11462 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$392.63 to $596.43
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $399.01 | $218.10 |
| Alaska* | $510.38 | $290.19 |
| Arizona | $436.26 | $235.92 |
| Arkansas | $392.63 | $215.03 |
| Atlanta | $459.45 | $249.39 |
| Austin | $466.49 | $247.75 |
| Bakersfield | $474.79 | $248.19 |
| Baltimore/Surr. Cntys | $480.32 | $258.48 |
| Beaumont | $418.33 | $230.18 |
| Brazoria | $442.68 | $237.79 |
| Chicago | $479.60 | $271.81 |
| Chico | $473.03 | $246.43 |
| Colorado | $467.21 | $247.23 |
| Connecticut | $481.46 | $258.79 |
| Dallas | $446.10 | $240.18 |
| Dc + Md/Va Suburbs | $516.08 | $272.52 |
| Delaware | $443.94 | $239.67 |
| Detroit | $452.68 | $253.16 |
| East St. Louis | $444.83 | $254.61 |
| El Centro | $473.14 | $246.54 |
| Fort Lauderdale | $471.14 | $261.70 |
| Fort Worth | $443.07 | $239.22 |
| Fresno | $473.03 | $246.43 |
| Galveston | $444.37 | $239.07 |
| Hanford-Corcoran | $473.03 | $246.43 |
| Hawaii, Guam | $485.83 | $250.76 |
| Houston | $456.08 | $250.78 |
| Idaho | $411.88 | $221.67 |
| Indiana | $414.47 | $222.82 |
| Iowa | $408.61 | $219.43 |
| Kansas | $407.26 | $220.36 |
| Kentucky | $411.09 | $227.29 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $506.86 | $262.27 |
| Madera | $473.03 | $246.43 |
| Manhattan | $521.88 | $281.64 |
| Merced | $473.03 | $246.43 |
| Metropolitan Boston | $515.32 | $268.46 |
| Metropolitan Kansas City | $428.93 | $234.79 |
| Metropolitan Philadelphia | $469.01 | $253.78 |
| Metropolitan St. Louis | $433.76 | $236.94 |
| Miami | $495.80 | $280.58 |
| Minnesota | $444.11 | $231.36 |
| Mississippi | $398.08 | $220.07 |
| Modesto | $473.03 | $246.43 |
| Montana** | $449.53 | $242.78 |
| Napa | $550.27 | $277.77 |
| Nebraska | $410.84 | $220.01 |
| Nevada** | $446.34 | $239.38 |
| New Hampshire | $460.45 | $245.22 |
| New Mexico | $426.46 | $236.86 |
| New Orleans | $432.99 | $238.44 |
| North Carolina | $419.73 | $226.83 |
| North Dakota** | $436.88 | $230.13 |
| Northern Nj | $510.05 | $270.22 |
| Nyc Suburbs/Long Island | $536.59 | $290.76 |
| Ohio | $421.01 | $232.24 |
| Oklahoma | $409.46 | $224.83 |
| Oxnard-Thousand Oaks-Ventura | $504.38 | $260.00 |
| Portland | $482.34 | $252.64 |
| Poughkpsie/N Nyc Suburbs | $489.85 | $263.46 |
| Puerto Rico | $452.89 | $243.86 |
| Queens | $525.41 | $281.03 |
| Redding | $473.03 | $246.43 |
| Rest Of California | $473.03 | $246.43 |
| Rest Of Florida | $445.79 | $248.14 |
| Rest Of Georgia | $418.00 | $233.58 |
| Rest Of Illinois | $432.87 | $244.11 |
| Rest Of Louisiana | $410.69 | $227.71 |
| Rest Of Maine | $415.07 | $224.86 |
| Rest Of Maryland | $452.77 | $243.53 |
| Rest Of Massachusetts | $464.31 | $246.60 |
| Rest Of Michigan | $423.59 | $234.83 |
| Rest Of Missouri | $403.43 | $225.21 |
| Rest Of New Jersey | $485.96 | $260.18 |
| Rest Of New York | $426.71 | $230.30 |
| Rest Of Oregon | $441.91 | $235.98 |
| Rest Of Pennsylvania | $421.31 | $231.51 |
| Rest Of Texas | $430.66 | $234.45 |
| Rest Of Washington | $463.25 | $245.54 |
| Rhode Island | $460.03 | $246.45 |
| Riverside-San Bernardino-Ontario | $479.91 | $253.31 |
| Sacramento-Roseville-Folsom | $497.03 | $256.57 |
| Salinas | $495.21 | $255.59 |
| San Diego-Chula Vista-Carlsbad | $507.47 | $260.19 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $582.75 | $291.23 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $582.02 | $290.50 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $596.43 | $298.29 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $593.46 | $295.32 |
| San Luis Obispo-Paso Robles | $487.24 | $251.75 |
| Santa Cruz-Watsonville | $512.73 | $261.53 |
| Santa Maria-Santa Barbara | $497.23 | $256.16 |
| Santa Rosa-Petaluma | $517.91 | $264.02 |
| Seattle (King Cnty) | $525.54 | $271.86 |
| South Carolina | $421.26 | $230.23 |
| South Dakota** | $435.38 | $228.63 |
| Southern Maine | $438.72 | $233.82 |
| Stockton | $473.03 | $246.43 |
| Suburban Chicago | $475.68 | $263.35 |
| Tennessee | $409.62 | $221.68 |
| Utah | $427.58 | $233.23 |
| Vallejo | $549.22 | $276.72 |
| Vermont | $435.71 | $231.03 |
| Virgin Islands | $452.89 | $243.86 |
| Virginia | $437.68 | $234.44 |
| Visalia | $473.03 | $246.43 |
| West Virginia | $415.52 | $235.85 |
| Wisconsin | $420.91 | $222.84 |
| Wyoming** | $444.02 | $237.27 |
| Yuba City | $473.03 | $246.43 |
11462 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$392.63
$534.73
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $510.38 | 1 |
| AL | $399.01 | 1 |
| AR | $392.63 | 1 |
| AZ | $436.26 | 1 |
| CA | $473.03–$596.43 | 29 |
| CO | $467.21 | 1 |
| CT | $481.46 | 1 |
| DC | $516.08 | 1 |
| DE | $443.94 | 1 |
| FL | $445.79–$495.80 | 3 |
| GA | $418.00–$459.45 | 2 |
| GU | $485.83 | 1 |
| HI | $485.83 | 1 |
| IA | $408.61 | 1 |
| ID | $411.88 | 1 |
| IL | $432.87–$479.60 | 4 |
| IN | $414.47 | 1 |
| KS | $407.26 | 1 |
| KY | $411.09 | 1 |
| LA | $410.69–$432.99 | 2 |
| MA | $464.31–$515.32 | 2 |
| MD | $452.77–$516.08 | 3 |
| ME | $415.07–$438.72 | 2 |
| MI | $423.59–$452.68 | 2 |
| MN | $444.11 | 1 |
| MO | $403.43–$433.76 | 3 |
| MS | $398.08 | 1 |
| MT | $449.53 | 1 |
| NC | $419.73 | 1 |
| ND | $436.88 | 1 |
| NE | $410.84 | 1 |
| NH | $460.45 | 1 |
| NJ | $485.96–$510.05 | 2 |
| NM | $426.46 | 1 |
| NV | $446.34 | 1 |
| NY | $426.71–$536.59 | 5 |
| OH | $421.01 | 1 |
| OK | $409.46 | 1 |
| OR | $441.91–$482.34 | 2 |
| PA | $421.31–$469.01 | 2 |
| PR | $452.89 | 1 |
| RI | $460.03 | 1 |
| SC | $421.26 | 1 |
| SD | $435.38 | 1 |
| TN | $409.62 | 1 |
| TX | $418.33–$466.49 | 8 |
| UT | $427.58 | 1 |
| VA | $437.68–$516.08 | 2 |
| VI | $452.89 | 1 |
| VT | $435.71 | 1 |
| WA | $463.25–$525.54 | 2 |
| WI | $420.91 | 1 |
| WV | $415.52 | 1 |
| WY | $444.02 | 1 |
How the 11462 rate is calculated
Each of 11462’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.
How the rate is built · 11462
RVUs × geographic indexes × conversion factor
Work2.93
2.93 RVUs× 1.000 GPCI
Practice expense9.89
9.89 RVUs× 1.000 GPCI
Malpractice0.64
0.64 RVUs× 1.000 GPCI
Adjusted RVUs
13.4600
Conversion factor
$33.4009
Medicare rate
$449.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11462
11462 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11462
Hidradenitis excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 11462
Hidradenitis excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
11462 without 50 · national office
$449.58
Hidradenitis excision
11462-50 · Bilateral: 150%
$674.37
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
11462 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 11463Hidradenitis excision
- Both codes concern inguinal hidradenitis excision. Choose 11462 for simple or intermediate repair and 11463 for complex repair.
- 11450Hidradenitis excision
- This code concerns hidradenitis excision in the axilla with simple or intermediate repair; 11462 is for the inguinal region.
- 11470Hidradenitis excision
- This code covers hidradenitis excision at specified perianal, perineal, pubic, or umbilical sites with simple or intermediate repair, rather than the inguinal region.
11462 billing questions
When should I choose 11462 rather than 11463?
Use 11462 for inguinal hidradenitis excision with simple or intermediate repair. Use 11463 when the inguinal wound requires complex repair.
Can the closure be billed separately?
The simple or intermediate repair is included in 11462. Do not report a separate repair code for that closure.
How is bilateral inguinal treatment reported?
CMS identifies this as a bilateral procedure: report modifier 50 when both sides are treated, with payment at 150%.
What documentation supports 11462?
Document hidradenitis, the inguinal location, the tissue excised, and whether the wound received a simple or intermediate repair.
How does the 90-day global period affect follow-up?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
When is an assistant at surgery payable?
CMS pays an assistant at surgery only when medical necessity is documented.
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
Show the CMS file lines behind this rate
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