$187.13–$203.70
Use 11403 when the lesion plus required margins measures 2.1–3 cm; 11404 begins at 3.1 cm.
On this page
CMS RVU26D · Effective 2026-10-01
11404 Skin excision Medicare reimbursement rates in Georgia
Removal of a benign skin lesion on the trunk, arm, or leg when the lesion and required margins measure 3.1 to 4 cm. Compare 11404 office and facility rates across CMS payment localities in Georgia.
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 11404 in Georgia?
Georgia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$217.21–$236.16
2 of 2 localities have a supported rate.
Facility setting
$146.60–$155.74
2 of 2 localities have a supported rate.
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 11404: Benign trunk or extremity lesion excision
Removal of a benign skin lesion on the trunk, arm, or leg when the lesion and required margins measure 3.1 to 4 cm.
This service involves removing a benign skin lesion from the trunk or an extremity, such as a benign-appearing nevus or epidermal cyst. Dermatologists, primary care clinicians, and surgeons commonly perform it in an office or outpatient procedure setting. The code selection is based on the lesion’s greatest diameter plus the narrowest margins needed for removal, measured before excision—not the length of the resulting wound.
Document the lesion’s site and dimensions, the margins included in the excision, and the procedure performed. Routine simple closure is included; a separately reportable intermediate or complex repair may be coded when performed and documented. Related postoperative visits are included in the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 11404
- 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 RVU2.06 · 30%
- Practice expense (office) RVU4.50 · 65%
- Malpractice RVU0.36 · 5%
16.2K
Medicare services in 2024 · #1231 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.
11404 compared with similar codes
Office rates for Georgia, from the same CMS release.
$316.42–$341.48
Use 11406 when the lesion plus required margins measures more than 4 cm; 11404 ends at 4 cm.
$229.93–$248.96
The size range is the same, but 11424 is for the hand, foot, neck, or genital area rather than the trunk or extremities covered by 11404.
$272.65–$294.17
The size range is the same, but 11444 applies to facial lesions; 11404 applies to the trunk and extremities.
Compare 11404 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.
2 of 2 payment localities
Atlanta →
Office / nonfacility
$236.16
Facility
$155.74
Rest Of Georgia →
Office / nonfacility
$217.21
Facility
$146.60
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11404 billing questions
How do I distinguish 11404 from 11403 or 11406?
Measure the lesion together with the margins required for excision. Use 11404 when that measurement is 3.1–4 cm; 11403 is for the smaller adjacent size range, and 11406 is for a measurement greater than 4 cm.
Can I report 11404 for a lesion on the hand or face?
No. This code is for the trunk and extremities other than the anatomic areas assigned to separate code series. Hand, foot, neck, and genital sites use the 11420–11426 series; facial sites use the 11440–11446 series.
Is wound closure included?
Simple closure is included in the excision. A separately reportable intermediate or complex repair may be coded when that repair is actually performed and documented.
Does the 10-day global period include postoperative visits?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can modifier 50 be used for lesions removed on both sides?
No. The bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
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.
1,31011401,,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
1,31411406,,Exc tr-ext b9+marg >4.0 cm,A,,3.43,5.92,,2.75,,0.64,9.99,6.82,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31511420,,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