$147.64
The site group is the same, but 11421 applies when the excised diameter is 0.6 to 1.0 cm; 11420 is for 0.5 cm or less.
On this page
CMS RVU26D · Effective 2026-10-01
11420 Benign lesion excision Medicare reimbursement rates in Nebraska
Reports excision of a benign skin lesion measuring 0.5 cm or less, including margins, on the scalp, neck, hands, feet, or genitalia. Compare 11420 office and facility rates across CMS payment localities in Nebraska.
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 11420 in Nebraska?
Nebraska 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
$115.87
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$70.86
1 of 1 localities have a supported rate.
Payment area: Nebraska
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.
Dermatology procedure
About 11420: Small benign lesion excision at restricted sites
Reports excision of a benign skin lesion measuring 0.5 cm or less, including margins, on the scalp, neck, hands, feet, or genitalia.
This code covers surgical removal of a small benign skin lesion from the scalp, neck, a hand, a foot, or the genitalia. Dermatologists, primary care clinicians, and surgeons may perform the procedure in an office or facility. The coded size is the greatest diameter of the lesion plus the margins removed, not the lesion alone. A suspected nevus or cyst may be removed for treatment or diagnosis; the record should identify the site and document the excised diameter and benign clinical assessment.
Choose this code only when the site falls within this group and the excised diameter is 0.5 cm or less. Use the appropriate sibling code when the diameter is larger, or a different site-specific code for another body region. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed 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. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 11420
- 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 RVU1.00 · 27%
- Practice expense (office) RVU2.63 · 70%
- Malpractice RVU0.11 · 3%
13.2K
Medicare services in 2024 · #1333 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.
11420 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$118.34
Both report excision of a small benign lesion, but 11400 is for trunk or extremity sites outside the scalp, neck, hands, feet, and genitalia group.
$131.64
Use 11440 for benign lesion excision on the face, ears, eyelids, nose, or lips, not the site group covered by 11420.
$85.69
Use 11200 for skin-tag removal. Code 11420 is for excision of a benign lesion at a specified site, with size measured including margins.
Compare 11420 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
Nebraska →
Office / nonfacility
$115.87
Facility
$70.86
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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 11420 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
1,315
- Code
- 11420
- Physician work
- 1.00
- Practice expense
- 2.63
- Malpractice
- 0.11
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.00 | × 1.000 | 1.0000 |
| Practice expense | 2.63 | × 0.923 | 2.4275 |
| Malpractice | 0.11 | × 0.378 | 0.0416 |
| Total RVUs | 3.4691 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$115.87
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1 | 1 |
| Practice expense | 2.63 | 0.923 |
| Malpractice | 0.11 | 0.378 |
(1 × 1 + 2.63 × 0.923 + 0.11 × 0.378) × $33.4009 = $115.87
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1 | 1 |
| Practice expense | 1.17 | 0.923 |
| Malpractice | 0.11 | 0.378 |
(1 × 1 + 1.17 × 0.923 + 0.11 × 0.378) × $33.4009 = $70.86
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.
11420 billing questions
How is the lesion size determined?
Use the excised diameter, which includes the lesion and the margins removed. The documentation should support a diameter of 0.5 cm or less.
When should I choose 11421 instead?
Choose 11421 for a lesion at one of the same sites when the excised diameter is 0.6 to 1.0 cm. Code 11420 is limited to 0.5 cm or less.
Can modifier 50 be used for lesions on both sides?
No. Modifier 50 is inappropriate for this code. It describes an individual lesion excision, not a bilateral procedure.
Are postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure reduction and paid at 50%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. 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.
1,31211403,,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
1,31711422,,Exc h-f-nk-sp b9+marg 1.1-2,A,,1.64,3.53,,1.87,,0.21,5.38,3.72,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31811423,,Exc h-f-nk-sp b9+marg 2.1-3,A,,2.01,3.97,,2.02,,0.27,6.25,4.30,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068