Billing code 11402: Skin lesion excisionMedicare rate & RVUs in Utah
Report this code for excision of a benign skin lesion on the trunk, arms, or legs when the lesion and required margins measure 1.1–2 cm.
Medicare pays $163.33 for 11402 in the office in Utah (Utah). 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 11402 covers
This service removes a benign skin lesion from the trunk, an arm, or a leg, including the margins taken around it. Typical examples include an epidermal inclusion cyst or benign nevus removed in a physician office or outpatient setting. The code is specific to these body regions; lesions on the head, neck, hands, feet, or genitalia fall into different anatomic code families.
Select the size by adding the lesion’s greatest clinical diameter to the narrowest margins required for complete removal; the resulting excised diameter must be 1.1–2 cm. Document the site, benign lesion, and dimensions supporting that measurement. Simple closure is part of the excision; a separately qualifying intermediate or complex repair may be reported. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. The bilateral adjustment is unavailable, assistant-at-surgery payment is restricted, 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.
11402 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $163.33 | $98.96 |
How the 11402 rate is calculated
Each of 11402’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 · 11402
RVUs × geographic indexes × conversion factor
Work1.41
1.41 RVUs× 1.000 GPCI
Practice expense3.53
3.53 RVUs× 1.000 GPCI
Malpractice0.18
0.18 RVUs× 1.000 GPCI
Adjusted RVUs
5.1200
Conversion factor
$33.4009
Medicare rate
$171.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11402
11402 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11402
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 · 11402
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
11402 without 51 · national office
$171.01
Skin lesion excision
11402-51 · Second procedure: 50%
$85.51
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%).
11402 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 11401Benign lesion excision
- Both codes cover benign lesions on the trunk, arms, or legs. Choose 11401 when the lesion plus required margins measures 0.6–1 cm rather than 1.1–2 cm.
- 11403Benign lesion excision
- This is the next larger size level for benign lesions on the same body regions: the lesion plus margins measures 2.1–3 cm.
- 11422Skin lesion excision
- The size range is the same, but 11422 is for lesions on the head, neck, hands, feet, or genitalia rather than the trunk, arms, or legs.
- 11602Malignant lesion excision
- This code is for a malignant lesion on the trunk, arms, or legs in the same size range. Code 11402 is for a benign lesion.
11402 billing questions
How is the 1.1–2 cm size determined?
Use the lesion’s greatest clinical diameter plus the narrowest margins needed for complete removal. The combined measurement must be 1.1–2 cm.
Which body sites qualify for this code?
The code is for lesions on the trunk, arms, or legs. Head, neck, hands, feet, and genital lesions belong to different anatomic code families.
Can the closure be billed separately?
Simple closure is included in the excision. A separately qualifying intermediate or complex repair may be reported when the work and documentation support it.
Are postoperative visits separately billable during the global period?
Related postoperative visits for 10 days are included in this code’s global period.
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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