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CMS RVU26D · Effective 2026-10-01

11424 Lesion excision Medicare reimbursement rates in Maine

Reports excision of a benign skin lesion on the scalp, neck, hands, feet, or genitalia when the excised diameter, including margins, is 3.1 to 4 cm. Compare 11424 office and facility rates across CMS payment localities in Maine.

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 11424 in Maine?

Maine 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

$227.10–$237.91

2 of 2 localities have a supported rate.

Lowest: Rest Of Maine

Highest: Southern Maine

A spread of $10.81 per service.

Facility setting

$154.58–$159.79

2 of 2 localities have a supported rate.

Lowest: Rest Of Maine

Highest: Southern Maine

A spread of $5.21 per service.

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.

Find 11424 in your payment locality →

Dermatology procedure

About 11424: Benign lesion excision, special sites, 3.1-4 cm

Reports excision of a benign skin lesion on the scalp, neck, hands, feet, or genitalia when the excised diameter, including margins, is 3.1 to 4 cm.

This code describes removal of a benign skin lesion from the scalp, neck, hands, feet, or genitalia. A dermatologist, surgeon, or other qualified clinician excises the lesion through the skin, including the margins, in an office or facility setting. The code is selected by both anatomic site and the total excised diameter, not by the lesion’s appearance alone. Simple closure is included; a separately performed intermediate or complex repair may be reported when supported by the repair performed and its documentation.

Document the lesion’s site, benign nature, and excised diameter including margins. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. CMS lists assistant-at-surgery payment as statutorily restricted and does not permit co-surgeon or team-surgery payment.

CMS billing rules for 11424

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 RVU2.42 · 33%
  • Practice expense (office) RVU4.51 · 62%
  • Malpractice RVU0.37 · 5%

4.8K

Medicare services in 2024 · #1897 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.

11424 compared with similar codes

Office rates for Maine, from the same CMS release.

11423

Skin excision

Scalp, neck, hands, feet, or genitalia

$194.74–$204.23

Use 11423 for a benign lesion at the same sites when the excised diameter, including margins, is 2.1 to 3 cm. Use 11424 for 3.1 to 4 cm.

11426

Benign lesion excision

Scalp, neck, hands, feet, genitalia

$317.11–$330.46

Use 11426 when the excised diameter at these sites is greater than 4 cm; 11424 covers 3.1 to 4 cm.

11404

Skin excision

Trunk or extremity, 3.1–4 cm

$214.56–$225.34

The size range is the same, but 11404 applies to trunk and extremity sites rather than scalp, neck, hands, feet, or genitalia.

11624

Skin excision

3.1–4 cm excised diameter

$316.86–$331.59

Use 11624 for a malignant lesion excised from these sites in the same size range. Code 11424 is for benign lesions.

Compare 11424 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

Office and facility base rates · shared scale starting at $0

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11424 billing questions

How is the 3.1-to-4-cm size determined?

Use the total excised diameter, including the margins, rather than the lesion’s visible diameter alone. Record the measurement and site in the procedure note.

Which sites belong to this code?

Use this code for benign lesions excised from the scalp, neck, hands, feet, or genitalia. Other anatomic sites use their own excision code families.

Is simple closure separately billable?

Simple closure is included in the excision. A separately performed intermediate or complex repair may be reported when its documentation supports separate reporting.

Can modifier 50 be used for lesions on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; report the service according to the applicable lesion and site coding.

What postoperative care is included?

Related postoperative visits during the 10-day global period are included in the procedure payment.

How does CMS handle another procedure performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment is statutorily restricted, and co-surgeon and team-surgery payment 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.

RVUs for 11424PPRRVU2026_Oct_nonQPP.csv, line 1,319 (RVU26D)