Billing code 11470: Hidradenitis excisionMedicare rate & RVUs in Ohio
Reports excision of hidradenitis-affected skin and subcutaneous tissue in the perineal, perianal, or umbilical area with simple or intermediate repair.
Medicare pays $470.84 for 11470 in the office in Ohio (Ohio). 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 11470 covers
This code covers surgical removal of skin and underlying tissue affected by hidradenitis in the perineal, perianal, or umbilical area. The procedure treats chronic disease such as recurrent nodules, abscesses, and sinus tracts by excising involved tissue, rather than simply draining an acute collection. Dermatologic, general, or colorectal surgeons may perform it in an operating room or other surgical setting. The code includes simple or intermediate repair of the resulting wound.
Select this code for the specified anatomic areas and the included repair level; document the site and extent of the excision and the repair performed. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing 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.
11470 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $470.84 | $269.58 |
How the 11470 rate is calculated
Each of 11470’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 · 11470
RVUs × geographic indexes × conversion factor
Work3.65
3.65 RVUs× 1.000 GPCI
Practice expense10.57
10.57 RVUs× 1.000 GPCI
Malpractice0.79
0.79 RVUs× 1.000 GPCI
Adjusted RVUs
15.0100
Conversion factor
$33.4009
Medicare rate
$501.35
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11470
11470 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11470
Hidradenitis excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 11470
Hidradenitis excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11470 without 51 · national office
$501.35
Hidradenitis excision
11470-51 · Second procedure: 50%
$250.68
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%).
11470 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 11471Hidradenitis excision
- Choose 11471 rather than 11470 when the repair of the perineal, perianal, or umbilical excision wound is complex.
- 11462Hidradenitis excision
- Use 11462 for hidradenitis excision in the inguinal area with simple or intermediate repair; 11470 covers perineal, perianal, or umbilical areas.
- 11463Hidradenitis excision
- 11463 describes inguinal hidradenitis excision with complex repair, while 11470 is for the specified perineal, perianal, or umbilical sites with simple or intermediate repair.
- 10060Abscess drainage
- Use 10060 for drainage of an abscess when that is the service performed. 11470 is for excision of hidradenitis-affected tissue at its specified sites, with repair included.
11470 billing questions
How is 11470 distinguished from 11471?
Both cover hidradenitis excision in the perineal, perianal, or umbilical area. Use 11470 when the wound is closed with simple or intermediate repair; 11471 is for complex repair.
Can the repair be billed separately?
No. Simple or intermediate repair is included in 11470, so do not report a separate repair code for closing that excision wound.
Does 11470 apply to hidradenitis in the groin or axilla?
No. The code is for perineal, perianal, or umbilical disease. The hidradenitis excision family has separate codes for inguinal and axillary sites.
Should modifier 50 be appended for disease on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; its descriptor and anatomy make modifier 50 unsuitable.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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