$463.13–$488.43
Both codes cover perianal, perineal, or umbilical hidradenitis excision; choose 11471 for the complex service and 11470 for simple or intermediate excision.
On this page
CMS RVU26D · Effective 2026-10-01
11471 Hidradenitis excision Medicare reimbursement rates in Maine
Reports complex surgical removal of hidradenitis-affected skin and underlying tissue in the perianal, perineal, or umbilical region. Compare 11471 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 11471 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
$542.26–$570.62
2 of 2 localities have a supported rate.
Facility setting
$308.73–$319.06
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 surgery
About 11471: Complex hidradenitis excision, perineal region
Reports complex surgical removal of hidradenitis-affected skin and underlying tissue in the perianal, perineal, or umbilical region.
This code is for complex excision of skin and subcutaneous tissue affected by hidradenitis in the perianal, perineal, or umbilical region. Surgeons, including dermatologic and general surgeons, may perform the procedure in an operating room or an outpatient surgical setting to remove diseased tissue in these specified locations. The code distinguishes this service from the simple or intermediate excision service for the same regions.
Select the code based on the anatomic site and the complex nature of the procedure, and document the involved location, extent of excision, and operative details supporting complexity. The code includes a 90-day global period, covering the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 11471
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU4.77 · 27%
- Practice expense (office) RVU11.84 · 68%
- Malpractice RVU0.92 · 5%
172
Medicare services in 2024 · #4460 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.
11471 compared with similar codes
Office rates for Maine, from the same CMS release.
$531.01–$559.71
Both describe complex hidradenitis excision, but 11463 is for the inguinal region; 11471 is for perianal, perineal, or umbilical sites.
$529.82–$558.27
11451 is the complex hidradenitis excision code for the axillary region. The anatomic site, not just procedural complexity, separates it from 11471.
Compare 11471 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
Rest Of Maine →
Office / nonfacility
$542.26
Facility
$308.73
Southern Maine →
Office / nonfacility
$570.62
Facility
$319.06
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11471 billing questions
When should 11471 be selected instead of 11470?
Use 11471 for complex excision in the perianal, perineal, or umbilical region. Use 11470 when the excision in those regions is simple or intermediate.
How does the site affect code selection?
11471 is for hidradenitis excision in the perianal, perineal, or umbilical region. Axillary and inguinal excisions are represented by different codes.
Is closure separately reported?
The code distinguishes complex excision from the simple or intermediate service for these sites. Do not separately report the closure as though it were the simple or intermediate service.
Can modifier 50 be used for bilateral disease?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What documentation supports reporting 11471?
Document the perianal, perineal, or umbilical site, the hidradenitis-related tissue removed, and operative details supporting the complex service.
What assistant-surgeon and global rules apply?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery 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.
1,32911462,,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
1,33211471,,Exc skn h/p/p/u complex,A,,4.77,11.84,,4.24,,0.92,17.53,9.93,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,3331150F,,Doc pt rsk death w/in 1yr,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,3341151F,,Doc no pt rsk death w/in 1yr,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,3351152F,,Doc advncd dis comfort 1st,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00