$197.61
Use 11403 for the same excised diameter when the benign lesion is on the trunk or an extremity. This code is for the scalp, neck, hands, feet, or genitalia.
On this page
CMS RVU26D · Effective 2026-10-01
11423 Skin excision Medicare reimbursement rates in Delaware
Removal of a benign skin lesion from the scalp, neck, hands, feet, or genitalia when its excised diameter, including margins, is 2.1 to 3.0 cm. Compare 11423 office and facility rates across CMS payment localities in Delaware.
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 11423 in Delaware?
Delaware 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
$206.59
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$142.24
1 of 1 localities have a supported rate.
Payment area: Delaware
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 11423: Benign lesion excision, scalp or extremity
Removal of a benign skin lesion from the scalp, neck, hands, feet, or genitalia when its excised diameter, including margins, is 2.1 to 3.0 cm.
This service removes a clinically benign skin lesion from the scalp, neck, hand, foot, or genital area, with the surrounding margin included in the excision. Dermatologists, surgeons, and other qualified clinicians commonly perform it in an office or outpatient setting. The code is selected by both the anatomic group and the excised diameter, measured across the lesion and margins; a 2.1-to-3.0 cm measurement falls in this size level.
The operative note should identify the site, lesion, and excised diameter, including margins. A simple closure is included in the excision; a separately reportable more extensive repair may be coded when supported. This is a minor procedure with a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 11423
- 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 RVU2.01 · 32%
- Practice expense (office) RVU3.97 · 64%
- Malpractice RVU0.27 · 4%
14.1K
Medicare services in 2024 · #1291 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.
11423 compared with similar codes
Office rates for Delaware, from the same CMS release.
$177.85
This code is for an excised diameter of 2.1 to 3.0 cm; 11422 is the same anatomic group but covers 1.1 to 2.0 cm.
$227.77
Both cover benign lesions at the 2.1-to-3.0 cm size level, but 11443 is for the face or mucous membrane rather than this code’s anatomic group.
$292.31
Use 11623 for a malignant lesion in this anatomic group and size range. This code is for a benign lesion.
Compare 11423 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
Delaware →
Office / nonfacility
$206.59
Facility
$142.24
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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 11423 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
1,318
- Code
- 11423
- Physician work
- 2.01
- Practice expense
- 3.97
- Malpractice
- 0.27
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.01 | × 1.005 | 2.0200 |
| Practice expense | 3.97 | × 0.988 | 3.9224 |
| Malpractice | 0.27 | × 0.899 | 0.2427 |
| Total RVUs | 6.1851 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$206.59
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.01 | 1.005 |
| Practice expense | 3.97 | 0.988 |
| Malpractice | 0.27 | 0.899 |
(2.01 × 1.005 + 3.97 × 0.988 + 0.27 × 0.899) × $33.4009 = $206.59
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.01 | 1.005 |
| Practice expense | 2.02 | 0.988 |
| Malpractice | 0.27 | 0.899 |
(2.01 × 1.005 + 2.02 × 0.988 + 0.27 × 0.899) × $33.4009 = $142.24
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.
11423 billing questions
How is the 2.1-to-3.0 cm size determined?
Use the excised diameter, including the lesion and margins, rather than the lesion alone. Document the measurement and the anatomic site.
Which nearby code applies when the lesion is on the trunk or an extremity?
For a benign lesion on the trunk or an extremity, use the corresponding 11400-series code based on excised diameter. Code 11403 covers that anatomic group at the 2.1-to-3.0 cm level.
Can the repair be billed separately?
Simple closure is included. A more extensive repair may be separately reported when its complexity and documentation meet the requirements for a repair code.
Can modifier 50 be used for lesions on both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing 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.
1,31511420,,Exc h-f-nk-sp b9+marg 0.5/<,A,,1.00,2.63,,1.17,,0.11,3.74,2.28,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31611421,,Exc h-f-nk-sp b9+marg 0.6-1,A,,1.43,3.17,,1.36,,0.17,4.77,2.96,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31711422,,Exc h-f-nk-sp b9+marg 1.1-2,A,,1.64,3.53,,1.87,,0.21,5.38,3.72,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31811423,,Exc h-f-nk-sp b9+marg 2.1-3,A,,2.01,3.97,,2.02,,0.27,6.25,4.30,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31911424,,Exc h-f-nk-sp b9+marg 3.1-4,A,,2.42,4.51,,2.15,,0.37,7.30,4.94,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,32011426,,Exc h-f-nk-sp b9+marg >4 cm,A,,3.99,5.55,,2.70,,0.64,10.18,7.33,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,32111440,,Exc face-mm b9+marg 0.5 cm/<,A,,1.02,3.12,,1.80,,0.11,4.25,2.93,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503