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CMS RVU26D · Effective 2026-10-01

11463 in Chico

Office / nonfacility

$601.42

Base rate per service

Facility setting

$318.08

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Dermatologic surgery

About 11463: Inguinal hidradenitis excision with complex repair

Reports excision of hidradenitis-affected skin and subcutaneous tissue in the inguinal region when the wound requires complex repair.

Code 11463 describes surgical removal of affected skin and subcutaneous tissue for hidradenitis in the groin, with complex repair of the resulting wound. A typical case involves chronic, recurrent disease with involved nodules or sinus tracts in the inguinal fold, rather than drainage of a single acute abscess. Dermatologic, general, or plastic surgeons may perform the procedure in an office or outpatient surgical setting.

Select this code when the site is inguinal and the repair meets the complex level; the extent of excision alone does not determine the repair level. Document the location, tissue removed, disease extent, and work supporting complex closure. The repair is included in the code and is not separately reported. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session multiple procedures, the highest-valued procedure is paid in full and others at 50%. Modifier 50 bilateral payment is 150%; assistant-at-surgery payment requires documented medical necessity. Co-surgeons and team surgery are not permitted.

CMS billing rules for 11463

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral procedure with modifier 50 is paid at 150%.
Assistant at surgery
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU4.32 · 25%
  • Practice expense (office) RVU11.99 · 70%
  • Malpractice RVU0.88 · 5%

93

Medicare services in 2024 · #4929 by national volume

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.

11463 compared with similar codes

Office rates for Chico, from the same CMS release.

11462

Hidradenitis excision

Inguinal, simple/intermediate repair

$473.03

Both apply to inguinal hidradenitis excision. Choose 11463 for complex repair and 11462 for simple or intermediate repair.

11451

Axillary hidradenitis excision

Complex repair

$599.18

Both describe complex-repair hidradenitis excision, but 11451 is for the axillary site; 11463 is for the inguinal site.

11471

Hidradenitis excision

Perianal, perineal, or umbilical

$611.93

Both describe complex-repair hidradenitis excision, but 11471 is for perianal, perineal, or umbilical sites; 11463 is inguinal.

The same code, a different location

How does Chico compare?

In Bakersfield, the office rate for 11463 is $603.86—$2.44 higher than the $601.42 rate in Chico. Both use the same code, release and participation basis.

11463 across payment areas

Same release and payment basis · bars start at $0

  1. Chico · This locality

    $601.42

  2. Bakersfield

    $603.86

    $2.44 higher than Chico

  3. El Centro

    $601.57

    $0.15 higher than Chico

  4. Fresno

    $601.42

    The same base rate than Chico

  5. Hanford-Corcoran

    $601.42

    The same base rate than Chico

  6. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $643.49

    $42.07 higher than Chico

  7. Madera

    $601.42

    The same base rate than Chico

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 11463 ranges from $503.44 in Arkansas to $753.41 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Merced

    California · 11463

    Office

    $601.42

    Facility

    $318.08

    The same base rate than Chico for the office setting.

  • Modesto

    California · 11463

    Office

    $601.42

    Facility

    $318.08

    The same base rate than Chico for the office setting.

  • Napa

    California · 11463

    Office

    $696.14

    Facility

    $355.41

    $94.72 higher than Chico for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 11463

    Office

    $640.01

    Facility

    $334.43

    $38.59 higher than Chico for the office setting.

  • Redding

    California · 11463

    Office

    $601.42

    Facility

    $318.08

    The same base rate than Chico for the office setting.

  • Rest Of California

    California · 11463

    Office

    $601.42

    Facility

    $318.08

    The same base rate than Chico for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 11463

    Office

    $610.88

    Facility

    $327.54

    $9.46 higher than Chico for the office setting.

  • Sacramento-Roseville-Folsom

    California · 11463

    Office

    $631.00

    Facility

    $330.33

    $29.58 higher than Chico for the office setting.

  • Salinas

    California · 11463

    Office

    $628.67

    Facility

    $329.04

    $27.25 higher than Chico for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 11463

    Office

    $643.52

    Facility

    $334.33

    $42.10 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 11463

    Office

    $736.16

    Facility

    $371.65

    $134.74 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 11463

    Office

    $735.16

    Facility

    $370.65

    $133.74 higher than Chico for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 11463

    Office

    $753.41

    Facility

    $380.62

    $151.99 higher than Chico for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 11463

    Office

    $749.32

    Facility

    $376.53

    $147.90 higher than Chico for the office setting.

  • San Luis Obispo-Paso Robles

    California · 11463

    Office

    $618.64

    Facility

    $324.18

    $17.22 higher than Chico for the office setting.

  • Santa Cruz-Watsonville

    California · 11463

    Office

    $649.66

    Facility

    $335.55

    $48.24 higher than Chico for the office setting.

  • Santa Maria-Santa Barbara

    California · 11463

    Office

    $631.04

    Facility

    $329.60

    $29.62 higher than Chico for the office setting.

  • Santa Rosa-Petaluma

    California · 11463

    Office

    $656.16

    Facility

    $338.69

    $54.74 higher than Chico for the office setting.

  • Stockton

    California · 11463

    Office

    $601.42

    Facility

    $318.08

    The same base rate than Chico for the office setting.

  • Vallejo

    California · 11463

    Office

    $694.70

    Facility

    $353.97

    $93.28 higher than Chico for the office setting.

  • Visalia

    California · 11463

    Office

    $601.42

    Facility

    $318.08

    The same base rate than Chico for the office setting.

  • Yuba City

    California · 11463

    Office

    $601.42

    Facility

    $318.08

    The same base rate than Chico for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 11463

    Office

    $656.56

    Facility

    $352.02

    $55.14 higher than Chico for the office setting.

  • Miami

    Florida · 11463

    Office

    $635.52

    Facility

    $366.40

    $34.10 higher than Chico for the office setting.

  • Chicago

    Illinois · 11463

    Office

    $615.24

    Facility

    $355.42

    $13.82 higher than Chico for the office setting.

  • Manhattan

    New York · 11463

    Office

    $665.50

    Facility

    $365.09

    $64.08 higher than Chico for the office setting.

  • Alaska*

    Alaska · 11463

    Office

    $659.14

    Facility

    $383.81

    $57.72 higher than Chico for the office setting.

  • Alabama

    Alabama · 11463

    Office

    $511.35

    Facility

    $285.14

    $90.07 lower than Chico for the office setting.

  • Arkansas

    Arkansas · 11463

    Office

    $503.44

    Facility

    $281.37

    $97.98 lower than Chico for the office setting.

  • Arizona

    Arizona · 11463

    Office

    $557.51

    Facility

    $307.01

    $43.91 lower than Chico for the office setting.

  • Colorado

    Colorado · 11463

    Office

    $595.09

    Facility

    $320.02

    $6.33 lower than Chico for the office setting.

  • Connecticut

    Connecticut · 11463

    Office

    $614.06

    Facility

    $335.63

    $12.64 higher than Chico for the office setting.

  • Delaware

    Delaware · 11463

    Office

    $567.11

    Facility

    $311.69

    $34.31 lower than Chico for the office setting.

  • Fort Lauderdale

    Florida · 11463

    Office

    $603.12

    Facility

    $341.23

    $1.70 higher than Chico for the office setting.

  • Rest Of Florida

    Florida · 11463

    Office

    $571.33

    Facility

    $324.18

    $30.09 lower than Chico for the office setting.

  • Atlanta

    Georgia · 11463

    Office

    $586.91

    Facility

    $324.25

    $14.51 lower than Chico for the office setting.

  • Rest Of Georgia

    Georgia · 11463

    Office

    $536.55

    Facility

    $305.95

    $64.87 lower than Chico for the office setting.

  • Hawaii, Guam

    Hawaii · 11463

    Office

    $616.65

    Facility

    $322.71

    $15.23 higher than Chico for the office setting.

  • Iowa

    Iowa · 11463

    Office

    $522.40

    Facility

    $285.85

    $79.02 lower than Chico for the office setting.

  • Idaho

    Idaho · 11463

    Office

    $526.63

    Facility

    $288.79

    $74.79 lower than Chico for the office setting.

  • East St. Louis

    Illinois · 11463

    Office

    $571.93

    Facility

    $334.09

    $29.49 lower than Chico for the office setting.

  • Rest Of Illinois

    Illinois · 11463

    Office

    $555.87

    Facility

    $319.84

    $45.55 lower than Chico for the office setting.

  • Suburban Chicago

    Illinois · 11463

    Office

    $608.68

    Facility

    $343.17

    $7.26 higher than Chico for the office setting.

  • Indiana

    Indiana · 11463

    Office

    $529.82

    Facility

    $290.17

    $71.60 lower than Chico for the office setting.

  • Kansas

    Kansas · 11463

    Office

    $521.14

    Facility

    $287.43

    $80.28 lower than Chico for the office setting.

  • Kentucky

    Kentucky · 11463

    Office

    $527.21

    Facility

    $297.38

    $74.21 lower than Chico for the office setting.

  • New Orleans

    Louisiana · 11463

    Office

    $554.53

    Facility

    $311.26

    $46.89 lower than Chico for the office setting.

  • Rest Of Louisiana

    Louisiana · 11463

    Office

    $526.87

    Facility

    $298.08

    $74.55 lower than Chico for the office setting.

  • Metropolitan Boston

    Massachusetts · 11463

    Office

    $654.54

    Facility

    $345.86

    $53.12 higher than Chico for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 11463

    Office

    $591.73

    Facility

    $319.50

    $9.69 lower than Chico for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 11463

    Office

    $612.67

    Facility

    $335.28

    $11.25 higher than Chico for the office setting.

  • Rest Of Maryland

    Maryland · 11463

    Office

    $578.00

    Facility

    $316.37

    $23.42 lower than Chico for the office setting.

  • Rest Of Maine

    Maine · 11463

    Office

    $531.01

    Facility

    $293.17

    $70.41 lower than Chico for the office setting.

  • Southern Maine

    Maine · 11463

    Office

    $559.71

    Facility

    $303.51

    $41.71 lower than Chico for the office setting.

  • Detroit

    Michigan · 11463

    Office

    $580.31

    Facility

    $330.83

    $21.11 lower than Chico for the office setting.

  • Rest Of Michigan

    Michigan · 11463

    Office

    $543.11

    Facility

    $307.08

    $58.31 lower than Chico for the office setting.

  • Minnesota

    Minnesota · 11463

    Office

    $565.08

    Facility

    $299.06

    $36.34 lower than Chico for the office setting.

  • Metropolitan Kansas City

    Missouri · 11463

    Office

    $549.06

    Facility

    $306.30

    $52.36 lower than Chico for the office setting.

  • Metropolitan St. Louis

    Missouri · 11463

    Office

    $555.00

    Facility

    $308.88

    $46.42 lower than Chico for the office setting.

  • Rest Of Missouri

    Missouri · 11463

    Office

    $518.13

    Facility

    $295.28

    $83.29 lower than Chico for the office setting.

  • Mississippi

    Mississippi · 11463

    Office

    $510.82

    Facility

    $288.24

    $90.60 lower than Chico for the office setting.

  • Montana**

    Montana · 11463

    Office

    $574.10

    Facility

    $315.58

    $27.32 lower than Chico for the office setting.

  • North Carolina

    North Carolina · 11463

    Office

    $536.72

    Facility

    $295.52

    $64.70 lower than Chico for the office setting.

  • North Dakota**

    North Dakota · 11463

    Office

    $556.70

    Facility

    $298.18

    $44.72 lower than Chico for the office setting.

  • Nebraska

    Nebraska · 11463

    Office

    $525.04

    Facility

    $286.43

    $76.38 lower than Chico for the office setting.

  • New Hampshire

    New Hampshire · 11463

    Office

    $586.91

    Facility

    $317.78

    $14.51 lower than Chico for the office setting.

  • Northern Nj

    New Jersey · 11463

    Office

    $649.33

    Facility

    $349.44

    $47.91 higher than Chico for the office setting.

  • Rest Of New Jersey

    New Jersey · 11463

    Office

    $619.63

    Facility

    $337.32

    $18.21 higher than Chico for the office setting.

  • New Mexico

    New Mexico · 11463

    Office

    $546.83

    Facility

    $309.76

    $54.59 lower than Chico for the office setting.

  • Nevada**

    Nevada · 11463

    Office

    $569.65

    Facility

    $310.87

    $31.77 lower than Chico for the office setting.

  • Nyc Suburbs/Long Island

    New York · 11463

    Office

    $684.28

    Facility

    $376.89

    $82.86 higher than Chico for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 11463

    Office

    $624.87

    Facility

    $341.79

    $23.45 higher than Chico for the office setting.

  • Queens

    New York · 11463

    Office

    $669.27

    Facility

    $363.70

    $67.85 higher than Chico for the office setting.

  • Rest Of New York

    New York · 11463

    Office

    $545.41

    Facility

    $299.81

    $56.01 lower than Chico for the office setting.

  • Ohio

    Ohio · 11463

    Office

    $539.56

    Facility

    $303.52

    $61.86 lower than Chico for the office setting.

  • Oklahoma

    Oklahoma · 11463

    Office

    $524.76

    Facility

    $293.89

    $76.66 lower than Chico for the office setting.

  • Portland

    Oregon · 11463

    Office

    $613.40

    Facility

    $326.18

    $11.98 higher than Chico for the office setting.

  • Rest Of Oregon

    Oregon · 11463

    Office

    $563.83

    Facility

    $306.34

    $37.59 lower than Chico for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 11463

    Office

    $598.85

    Facility

    $329.73

    $2.57 lower than Chico for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 11463

    Office

    $539.71

    Facility

    $302.38

    $61.71 lower than Chico for the office setting.

  • Puerto Rico

    Puerto Rico · 11463

    Office

    $578.13

    Facility

    $316.76

    $23.29 lower than Chico for the office setting.

  • Rhode Island

    Rhode Island · 11463

    Office

    $586.94

    Facility

    $319.89

    $14.48 lower than Chico for the office setting.

  • South Carolina

    South Carolina · 11463

    Office

    $539.32

    Facility

    $300.44

    $62.10 lower than Chico for the office setting.

  • South Dakota**

    South Dakota · 11463

    Office

    $554.64

    Facility

    $296.12

    $46.78 lower than Chico for the office setting.

  • Tennessee

    Tennessee · 11463

    Office

    $524.11

    Facility

    $289.11

    $77.31 lower than Chico for the office setting.

  • Austin

    Texas · 11463

    Office

    $594.33

    Facility

    $320.81

    $7.09 lower than Chico for the office setting.

  • Beaumont

    Texas · 11463

    Office

    $536.03

    Facility

    $300.78

    $65.39 lower than Chico for the office setting.

  • Brazoria

    Texas · 11463

    Office

    $565.25

    Facility

    $309.05

    $36.17 lower than Chico for the office setting.

  • Dallas

    Texas · 11463

    Office

    $569.68

    Facility

    $312.20

    $31.74 lower than Chico for the office setting.

  • Fort Worth

    Texas · 11463

    Office

    $566.06

    Facility

    $311.16

    $35.36 lower than Chico for the office setting.

  • Galveston

    Texas · 11463

    Office

    $567.46

    Facility

    $310.74

    $33.96 lower than Chico for the office setting.

  • Houston

    Texas · 11463

    Office

    $583.56

    Facility

    $326.85

    $17.86 lower than Chico for the office setting.

  • Rest Of Texas

    Texas · 11463

    Office

    $550.89

    Facility

    $305.55

    $50.53 lower than Chico for the office setting.

  • Utah

    Utah · 11463

    Office

    $547.13

    Facility

    $304.12

    $54.29 lower than Chico for the office setting.

  • Virginia

    Virginia · 11463

    Office

    $558.71

    Facility

    $304.58

    $42.71 lower than Chico for the office setting.

  • Virgin Islands

    United States Virgin Islands · 11463

    Office

    $578.13

    Facility

    $316.76

    $23.29 lower than Chico for the office setting.

  • Vermont

    Vermont · 11463

    Office

    $555.64

    Facility

    $299.70

    $45.78 lower than Chico for the office setting.

  • Rest Of Washington

    Washington · 11463

    Office

    $590.24

    Facility

    $318.01

    $11.18 lower than Chico for the office setting.

  • Seattle (King Cnty)

    Washington · 11463

    Office

    $666.91

    Facility

    $349.70

    $65.49 higher than Chico for the office setting.

  • Wisconsin

    Wisconsin · 11463

    Office

    $537.00

    Facility

    $289.34

    $64.42 lower than Chico for the office setting.

  • West Virginia

    West Virginia · 11463

    Office

    $534.37

    Facility

    $309.71

    $67.05 lower than Chico for the office setting.

  • Wyoming**

    Wyoming · 11463

    Office

    $566.52

    Facility

    $308.00

    $34.90 lower than Chico for the office setting.

See how rates vary across the country

11463 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$503.44

$677.42

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$659.141
AL$511.351
AR$503.441
AZ$557.511
CA$601.42–$753.4129
CO$595.091
CT$614.061
DC$656.561
DE$567.111
FL$571.33–$635.523
GA$536.55–$586.912
GU$616.651
HI$616.651
IA$522.401
ID$526.631
IL$555.87–$615.244
IN$529.821
KS$521.141
KY$527.211
LA$526.87–$554.532
MA$591.73–$654.542
MD$578.00–$656.563
ME$531.01–$559.712
MI$543.11–$580.312
MN$565.081
MO$518.13–$555.003
MS$510.821
MT$574.101
NC$536.721
ND$556.701
NE$525.041
NH$586.911
NJ$619.63–$649.332
NM$546.831
NV$569.651
NY$545.41–$684.285
OH$539.561
OK$524.761
OR$563.83–$613.402
PA$539.71–$598.852
PR$578.131
RI$586.941
SC$539.321
SD$554.641
TN$524.111
TX$536.03–$594.338
UT$547.131
VA$558.71–$656.562
VI$578.131
VT$555.641
WA$590.24–$666.912
WI$537.001
WV$534.371
WY$566.521

Explore 11463 on the national rate map →

Where does this rate apply?

Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 11463 in Chico, the physician’s office rate is $601.42 and the facility-setting rate is $318.08: a difference of $283.34.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 11463 in Chico. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$661.56

$601.42 × 110% = $661.56

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 11463 in Chico.

PPRRVU2026_Oct_nonQPP.csv

1,330

Code
11463
Physician work
4.32
Practice expense
11.99
Malpractice
0.88

GPCI2026.csv

9

Locality
Chico
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 11463 in Chico
ComponentRVULocality factorAdjusted
Physician work4.32× 1.0174.3934
Practice expense11.99× 1.09613.1410
Malpractice0.88× 0.5360.4717
Total RVUs18.0062
Conversion factor× 33.4009

Office / nonfacility rate, Chico$601.42

Open 11463 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work4.321.017
Practice expense11.991.096
Malpractice0.880.536

(4.32 × 1.017 + 11.99 × 1.096 + 0.88 × 0.536) × $33.4009 = $601.42

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work4.321.017
Practice expense4.251.096
Malpractice0.880.536

(4.32 × 1.017 + 4.25 × 1.096 + 0.88 × 0.536) × $33.4009 = $318.08

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

11463 · Office / nonfacility

$601.42

Effective 2026-10-01

The base rate is $70.01 higher than on 2025-10-01, moving from $531.41 to $601.42 (13.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $531.41changed to$601.42

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.43 changed to 4.32
    • Practice expense RVU 10.47 changed to 11.99
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $531.41

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$601.42$318.08RVU26D
2026-07-01$601.42$318.08RVU26C
2026-04-01$601.42$318.08RVU26B
2026-01-01$601.42$318.08RVU26A
2025-10-01$531.41$329.88RVU25D
2025-07-01$531.41$329.88RVU25C
2025-04-01$531.41$329.88RVU25B
2025-01-01$531.41$329.88RVU25A

11463 billing questions

When should 11463 be chosen over 11462?

Both codes describe inguinal hidradenitis excision. Use 11463 when the wound requires complex repair; use 11462 when the repair is simple or intermediate.

Can the complex repair be billed separately?

No. The complex repair is included in 11463, so do not report a separate repair code for closing the excision wound.

What documentation supports the complex repair level?

Document the inguinal site, the diseased tissue removed, and the closure work that supports a complex repair. The size of the excision by itself does not establish that level.

How is bilateral inguinal treatment reported?

CMS lists bilateral payment with modifier 50 at 150%. Document the treated sides and follow applicable claim-line reporting instructions.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon be paid for this procedure?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 11463PPRRVU2026_Oct_nonQPP.csv, line 1,330 (RVU26D)
Geographic factors for ChicoGPCI2026.csv, line 9 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet