Billing code 11406: Skin lesion excisionMedicare rate & RVUs in Oregon
Reports excision of a benign skin lesion on the trunk, arm, or leg when the lesion plus margins measures more than 4.0 cm.
Medicare pays $326.54–$351.98 for 11406 in the office in Oregon, from Rest Of Oregon to Portland. 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 11406 covers
This service removes a benign skin lesion from the trunk, arm, or leg, with a margin of surrounding tissue. The code is selected when the excised diameter—the lesion’s greatest diameter plus the margins—is greater than 4.0 cm. Dermatologists, surgeons, and other clinicians who perform skin procedures may report it in an office or facility setting. It is not the site-specific code for lesions on the scalp, neck, hands, feet, or face.
Document the lesion’s location, benign diagnosis, size, margins, and total excised diameter. Simple wound closure is included; a separately reportable repair may be appropriate when a more complex closure is performed. Related postoperative visits during the 10-day global period are included. 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 multiple procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, 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.
Where 11406 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $351.98 | $234.35 |
| Rest Of Oregon | $326.54 | $221.08 |
How the 11406 rate is calculated
Each of 11406’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 · 11406
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.43Practice expense 5.92Malpractice 0.64
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11406
11406 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11406
Skin lesion 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 · 11406
Skin lesion 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
11406 without 51 · national office
$333.67
Skin lesion excision
11406-51 · Second procedure: 50%
$166.84
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%).
11406 compared with similar codes
Compare codes
11406 vs 11404 vs 11426 vs 11446: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 11404Skin excision
- Both cover benign lesion excision on the trunk, arms, or legs. Choose 11404 when the lesion plus margins measures 3.1–4.0 cm; choose 11406 when it exceeds 4.0 cm.
- 11426Benign lesion excision
- This code is for the scalp, neck, hands, or feet site group when the excised diameter exceeds 4.0 cm. Use 11406 for the trunk, arms, or legs at that size.
- 11446Skin lesion excision
- This code covers benign lesion excision over 4.0 cm on the face. Use 11406 for the trunk, arms, or legs.
11406 billing questions
How is the size threshold determined?
Use the lesion’s greatest diameter plus the margins removed. Report this level when that total excised diameter is greater than 4.0 cm.
Which site codes should I compare?
Use this code for the trunk, arms, or legs. Lesions on the scalp, neck, hands, or feet follow a separate site series, as do lesions on the face.
Can I separately bill the closure?
Simple closure is included in the excision. A more complex repair may be separately reportable when supported by the procedure performed and documented.
Can I append modifier 50 for two sides?
No. CMS identifies bilateral adjustment as inapplicable to this code and modifier 50 as inappropriate.
Are assistant or co-surgeon services payable?
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 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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