$418.52
Both are for axillary hidradenitis excision. The repair level distinguishes them: 11450 covers simple or intermediate repair, while 11451 covers complex repair.
On this page
CMS RVU26D · Effective 2026-10-01
11451 Axillary hidradenitis excision Medicare reimbursement rates in Iowa
Reports excision of axillary skin and subcutaneous tissue for hidradenitis when the resulting wound is managed with complex repair. Compare 11451 office and facility rates across CMS payment localities in Iowa.
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 11451 in Iowa?
Iowa 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
$520.32
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$287.75
1 of 1 localities have a supported rate.
Payment area: Iowa
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.
Dermatologic surgery
About 11451: Axillary hidradenitis excision, complex repair
Reports excision of axillary skin and subcutaneous tissue for hidradenitis when the resulting wound is managed with complex repair.
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.
CMS billing rules for 11451
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.32 · 25%
- Practice expense (office) RVU11.87 · 69%
- Malpractice RVU1.00 · 6%
78
Medicare services in 2024 · #5072 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.
11451 compared with similar codes
Office rates for Iowa, from the same CMS release.
$522.40
This code covers complex repair after hidradenitis excision in the inguinal region, not the axilla.
$533.37
This code covers complex repair after hidradenitis excision at perianal, perineal, or umbilical sites, rather than the axilla.
Compare 11451 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
Iowa →
Office / nonfacility
$520.32
Facility
$287.75
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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 11451 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
1,328
- Code
- 11451
- Physician work
- 4.32
- Practice expense
- 11.87
- Malpractice
- 1.00
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.32 | × 1.000 | 4.3200 |
| Practice expense | 11.87 | × 0.915 | 10.8611 |
| Malpractice | 1.00 | × 0.397 | 0.3970 |
| Total RVUs | 15.5781 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$520.32
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.32 | 1 |
| Practice expense | 11.87 | 0.915 |
| Malpractice | 1 | 0.397 |
(4.32 × 1 + 11.87 × 0.915 + 1 × 0.397) × $33.4009 = $520.32
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.32 | 1 |
| Practice expense | 4.26 | 0.915 |
| Malpractice | 1 | 0.397 |
(4.32 × 1 + 4.26 × 0.915 + 1 × 0.397) × $33.4009 = $287.75
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.
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 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.
1,32511444,,Exc face-mm b9+marg 3.1-4 cm,A,,3.11,5.09,,2.45,,0.43,8.63,5.99,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,32611446,,Exc face-mm b9+marg >4 cm,A,,4.68,6.57,,3.10,,0.68,11.93,8.46,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,32711450,,Exc skn hdrdnt ax smpl/ntrm,A,,3.14,9.95,,3.77,,0.72,13.81,7.63,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136