$136.59
Both cover benign-lesion excision on the trunk or extremities; 11400 is for an excised diameter below 0.6 cm, while 11401 covers 0.6 through 1.0 cm.
On this page
CMS RVU26D · Effective 2026-10-01
11401 Benign lesion excision Medicare reimbursement rates in Connecticut
Reports excision of a benign skin lesion on the trunk, arms, or legs when the lesion and narrowest margins measure 0.6 through 1.0 cm. Compare 11401 office and facility rates across CMS payment localities in Connecticut.
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 11401 in Connecticut?
Connecticut 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
$165.24
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
$100.13
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 procedure
About 11401: Benign lesion excision, trunk or extremity
Reports excision of a benign skin lesion on the trunk, arms, or legs when the lesion and narrowest margins measure 0.6 through 1.0 cm.
A physician or other qualified practitioner excises a benign skin lesion from the trunk or an extremity, removing the lesion through the dermis with the margins needed for complete removal. Typical office cases include excision of a benign nevus or cyst from the back, arm, or leg. The code family is organized by both anatomic site and the diameter of the excised area, not by the lesion’s appearance alone.
Choose this level using the greatest diameter of the lesion plus the narrowest margins required for excision; document the site and measurement. Simple closure is included, while a separately performed intermediate or complex repair may be reported when its requirements are met and documented. Related postoperative visits during the 10-day global period are included. For multiple procedures in one session, CMS pays the highest-valued procedure in full and reduces the others to 50%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 11401
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU1.25 · 27%
- Practice expense (office) RVU3.23 · 70%
- Malpractice RVU0.16 · 3%
48.5K
Medicare services in 2024 · #790 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.
11401 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$182.30
Both cover the same sites, but 11402 applies when the excised diameter is 1.1 through 2.0 cm.
$169.62
The size range matches, but 11421 is for the scalp, neck, hands, or feet rather than the trunk, arms, or legs.
$185.07
The size range matches, but 11441 is for the face and related sites, not the trunk or extremities.
Compare 11401 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
Connecticut →
Office / nonfacility
$165.24
Facility
$100.13
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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 11401 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
1,310
- Code
- 11401
- Physician work
- 1.25
- Practice expense
- 3.23
- Malpractice
- 0.16
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.25 | × 1.020 | 1.2750 |
| Practice expense | 3.23 | × 1.077 | 3.4787 |
| Malpractice | 0.16 | × 1.210 | 0.1936 |
| Total RVUs | 4.9473 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$165.24
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.25 | 1.02 |
| Practice expense | 3.23 | 1.077 |
| Malpractice | 0.16 | 1.21 |
(1.25 × 1.02 + 3.23 × 1.077 + 0.16 × 1.21) × $33.4009 = $165.24
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.25 | 1.02 |
| Practice expense | 1.42 | 1.077 |
| Malpractice | 0.16 | 1.21 |
(1.25 × 1.02 + 1.42 × 1.077 + 0.16 × 1.21) × $33.4009 = $100.13
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.
11401 billing questions
How is the 0.6–1 cm size determined?
Measure the lesion together with the narrowest margins removed, using the greatest diameter of the excised area. Document the measurement and the anatomic site.
When should I use 11401 instead of 11400 or 11402?
Use 11401 for a trunk or extremity excision measuring 0.6 through 1.0 cm. Code 11400 is for the smaller size level, and 11402 is for the next larger level.
Does the excision code include wound closure?
Simple closure is included. A separately performed intermediate or complex repair may be reported when the repair independently meets the applicable requirements and is documented.
Can I use 11401 for a lesion on the face or scalp?
No. This code is for the trunk, arms, and legs; select the excision family for the actual site, such as the separate face or scalp, neck, hands, and feet families.
Are postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
How does CMS handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple procedure reduction, with payment at 50%.
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.
1,3071136F,,Epsd bk pain for 12 wks/<,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
1,3081137F,,Epsd bk pain for >12 wks,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
1,30911400,,Exc tr-ext b9+marg 0.5 cm<,A,,0.88,2.84,,1.30,,0.11,3.83,2.29,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31011401,,Exc tr-ext b9+marg 0.6-1 cm,A,,1.25,3.23,,1.42,,0.16,4.64,2.83,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31111402,,Exc tr-ext b9+marg 1.1-2 cm,A,,1.41,3.53,,1.48,,0.18,5.12,3.07,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31211403,,Exc tr-ext b9+marg 2.1-3cm,A,,1.79,3.94,,2.02,,0.25,5.98,4.06,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31311404,,Exc tr-ext b9+marg 3.1-4 cm,A,,2.06,4.50,,2.13,,0.36,6.92,4.55,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808