Billing code 11451: Axillary hidradenitis excisionMedicare rate & RVUs in Florida
Reports excision of axillary skin and subcutaneous tissue for hidradenitis when the resulting wound is managed with complex repair.
Medicare pays $573.52–$641.49 for 11451 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
What 11451 covers
This code is for surgical removal of skin and underlying subcutaneous tissue affected by hidradenitis in the axilla, with complex repair of the resulting wound. Dermatologic, general, or plastic surgeons may perform the procedure, commonly in a facility setting for more extensive disease. The code is specific to the axilla; disease at other sites uses the corresponding hidradenitis excision code for that location.
Choose this code when the axillary excision is accompanied by complex repair, rather than simple or intermediate repair. Document the operative site and laterality, excision performed, and repair details supporting the complex level. The repair is included in this service and should not be separately unbundled. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued 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 11451 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$573.52 to $641.49
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $606.30 | $348.82 |
| Miami | $641.49 | $376.88 |
| Rest Of Florida | $573.52 | $330.52 |
How the 11451 rate is calculated
Each of 11451’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 · 11451
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.32Practice expense 11.87Malpractice 1.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11451
11451 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11451
Axillary 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 · 11451
Axillary 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
11451 without 50 · national office
$574.16
Axillary hidradenitis excision
11451-50 · Bilateral: 150%
$861.24
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).
11451 compared with similar codes
Compare codes
11451 vs 11450 vs 11463 vs 11471: national Medicare rates
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How to choose
- 11450Hidradenitis excision
- Both are for axillary hidradenitis excision. The repair level distinguishes them: 11450 covers simple or intermediate repair, while 11451 covers complex repair.
- 11463Hidradenitis excision
- This code covers complex repair after hidradenitis excision in the inguinal region, not the axilla.
- 11471Hidradenitis excision
- This code covers complex repair after hidradenitis excision at perianal, perineal, or umbilical sites, rather than the axilla.
11451 billing questions
When should 11451 be chosen over 11450?
Both cover axillary hidradenitis excision. Choose 11451 when the wound receives complex repair; 11450 is for simple or intermediate repair.
Can the complex closure be billed separately?
No. Complex repair is part of 11451, so it is not separately reported as a repair service for the same wound.
How is bilateral axillary surgery reported?
Report modifier 50 for a bilateral procedure. CMS pays the bilateral service at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does CMS handle other procedures performed in the same session?
The highest-valued procedure is paid in full; additional procedures are paid at 50%. Assistant-at-surgery payment requires documented medical necessity.
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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