$606.01
Choose 11471 rather than 11470 when the repair of the perineal, perianal, or umbilical excision wound is complex.
On this page
CMS RVU26D · Effective 2026-10-01
11470 Hidradenitis excision Medicare reimbursement rates in Colorado
Reports excision of hidradenitis-affected skin and subcutaneous tissue in the perineal, perianal, or umbilical area with simple or intermediate repair. Compare 11470 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for 11470 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$519.63
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$285.07
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Dermatology surgery
About 11470: Perineal hidradenitis excision with simple repair
Reports excision of hidradenitis-affected skin and subcutaneous tissue in the perineal, perianal, or umbilical area with simple or intermediate repair.
This code covers surgical removal of skin and underlying tissue affected by hidradenitis in the perineal, perianal, or umbilical area. The procedure treats chronic disease such as recurrent nodules, abscesses, and sinus tracts by excising involved tissue, rather than simply draining an acute collection. Dermatologic, general, or colorectal surgeons may perform it in an operating room or other surgical setting. The code includes simple or intermediate repair of the resulting wound.
Select this code for the specified anatomic areas and the included repair level; document the site and extent of the excision and the repair performed. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 11470
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.65 · 24%
- Practice expense (office) RVU10.57 · 70%
- Malpractice RVU0.79 · 5%
370
Medicare services in 2024 · #3796 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.
11470 compared with similar codes
Office rates for Colorado, from the same CMS release.
$467.21
Use 11462 for hidradenitis excision in the inguinal area with simple or intermediate repair; 11470 covers perineal, perianal, or umbilical areas.
$595.09
11463 describes inguinal hidradenitis excision with complex repair, while 11470 is for the specified perineal, perianal, or umbilical sites with simple or intermediate repair.
$133.53
Use 10060 for drainage of an abscess when that is the service performed. 11470 is for excision of hidradenitis-affected tissue at its specified sites, with repair included.
Compare 11470 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
$519.63
Facility
$285.07
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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 11470 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
1,331
- Code
- 11470
- Physician work
- 3.65
- Practice expense
- 10.57
- Malpractice
- 0.79
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.65 | × 1.012 | 3.6938 |
| Practice expense | 10.57 | × 1.064 | 11.2465 |
| Malpractice | 0.79 | × 0.781 | 0.6170 |
| Total RVUs | 15.5573 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$519.63
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.65 | 1.012 |
| Practice expense | 10.57 | 1.064 |
| Malpractice | 0.79 | 0.781 |
(3.65 × 1.012 + 10.57 × 1.064 + 0.79 × 0.781) × $33.4009 = $519.63
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.65 | 1.012 |
| Practice expense | 3.97 | 1.064 |
| Malpractice | 0.79 | 0.781 |
(3.65 × 1.012 + 3.97 × 1.064 + 0.79 × 0.781) × $33.4009 = $285.07
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.
11470 billing questions
How is 11470 distinguished from 11471?
Both cover hidradenitis excision in the perineal, perianal, or umbilical area. Use 11470 when the wound is closed with simple or intermediate repair; 11471 is for complex repair.
Can the repair be billed separately?
No. Simple or intermediate repair is included in 11470, so do not report a separate repair code for closing that excision wound.
Does 11470 apply to hidradenitis in the groin or axilla?
No. The code is for perineal, perianal, or umbilical disease. The hidradenitis excision family has separate codes for inguinal and axillary sites.
Should modifier 50 be appended for disease on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; its descriptor and anatomy make modifier 50 unsuitable.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
1,32811451,,Exc skn hdrdnt ax complex,A,,4.32,11.87,,4.26,,1.00,17.19,9.58,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,32911462,,Exc skn hdrdnt ing smpl/ntrm,A,,2.93,9.89,,3.70,,0.64,13.46,7.27,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,33011463,,Exc skn hdrdnt ing complex,A,,4.32,11.99,,4.25,,0.88,17.19,9.45,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,33111470,,Exc skn h/p/p/u smpl/ntrm,A,,3.65,10.57,,3.97,,0.79,15.01,8.41,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,33211471,,Exc skn h/p/p/u complex,A,,4.77,11.84,,4.24,,0.92,17.53,9.93,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,3331150F,,Doc pt rsk death w/in 1yr,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,3341151F,,Doc no pt rsk death w/in 1yr,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899