CPT code 11404: Skin excision2026 Medicare rate & RVUs in Nebraska
Removal of a benign skin lesion on the trunk, arm, or leg when the lesion and required margins measure 3.1 to 4 cm.
Medicare pays $212.08 for 11404 in the office in Nebraska (Nebraska). 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 11404 covers
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.
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 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | $212.08 | $139.02 |
How the 11404 rate is calculated
Each of 11404’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 · 11404
RVUs × geographic indexes × conversion factor
Work2.06
2.06 RVUs× 1.000 GPCI
Practice expense4.50
4.50 RVUs× 1.000 GPCI
Malpractice0.36
0.36 RVUs× 1.000 GPCI
Adjusted RVUs
6.9200
Conversion factor
$33.4009
Medicare rate
$231.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11404
11404 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11404
Skin excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| 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) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 11404
Skin excision
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11404 without 51 · national office
$231.13
Skin excision
11404-51 · Second procedure: 50%
$115.57
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
11404 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 11403Benign lesion excision
- Use 11403 when the lesion plus required margins measures 2.1–3 cm; 11404 begins at 3.1 cm.
- 11406Skin lesion excision
- Use 11406 when the lesion plus required margins measures more than 4 cm; 11404 ends at 4 cm.
- 11424Lesion excision
- 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.
- 11444Skin excision
- The size range is the same, but 11444 applies to facial lesions; 11404 applies to the trunk and extremities.
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 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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