$202.97
Use 11423 for a benign lesion at the same sites when the excised diameter, including margins, is 2.1 to 3 cm. Use 11424 for 3.1 to 4 cm.
On this page
CMS RVU26D · Effective 2026-10-01
11424 Lesion excision Medicare reimbursement rates in Vermont
Reports excision of a benign skin lesion on the scalp, neck, hands, feet, or genitalia when the excised diameter, including margins, is 3.1 to 4 cm. Compare 11424 office and facility rates across CMS payment localities in Vermont.
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 11424 in Vermont?
Vermont 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
$236.22
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$158.18
1 of 1 localities have a supported rate.
Payment area: Vermont
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 11424: Benign lesion excision, special sites, 3.1-4 cm
Reports excision of a benign skin lesion on the scalp, neck, hands, feet, or genitalia when the excised diameter, including margins, is 3.1 to 4 cm.
This code describes removal of a benign skin lesion from the scalp, neck, hands, feet, or genitalia. A dermatologist, surgeon, or other qualified clinician excises the lesion through the skin, including the margins, in an office or facility setting. The code is selected by both anatomic site and the total excised diameter, not by the lesion’s appearance alone. Simple closure is included; a separately performed intermediate or complex repair may be reported when supported by the repair performed and its documentation.
Document the lesion’s site, benign nature, and excised diameter including margins. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. CMS lists assistant-at-surgery payment as statutorily restricted and does not permit co-surgeon or team-surgery payment.
CMS billing rules for 11424
- 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 RVU2.42 · 33%
- Practice expense (office) RVU4.51 · 62%
- Malpractice RVU0.37 · 5%
4.8K
Medicare services in 2024 · #1897 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.
11424 compared with similar codes
Office rates for Vermont, from the same CMS release.
$327.61
Use 11426 when the excised diameter at these sites is greater than 4 cm; 11424 covers 3.1 to 4 cm.
$223.69
The size range is the same, but 11404 applies to trunk and extremity sites rather than scalp, neck, hands, feet, or genitalia.
$329.38
Use 11624 for a malignant lesion excised from these sites in the same size range. Code 11424 is for benign lesions.
Compare 11424 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
Vermont →
Office / nonfacility
$236.22
Facility
$158.18
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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 11424 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
1,319
- Code
- 11424
- Physician work
- 2.42
- Practice expense
- 4.51
- Malpractice
- 0.37
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.42 | × 1.000 | 2.4200 |
| Practice expense | 4.51 | × 0.990 | 4.4649 |
| Malpractice | 0.37 | × 0.506 | 0.1872 |
| Total RVUs | 7.0721 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$236.22
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.42 | 1 |
| Practice expense | 4.51 | 0.99 |
| Malpractice | 0.37 | 0.506 |
(2.42 × 1 + 4.51 × 0.99 + 0.37 × 0.506) × $33.4009 = $236.22
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.42 | 1 |
| Practice expense | 2.15 | 0.99 |
| Malpractice | 0.37 | 0.506 |
(2.42 × 1 + 2.15 × 0.99 + 0.37 × 0.506) × $33.4009 = $158.18
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.
11424 billing questions
How is the 3.1-to-4-cm size determined?
Use the total excised diameter, including the margins, rather than the lesion’s visible diameter alone. Record the measurement and site in the procedure note.
Which sites belong to this code?
Use this code for benign lesions excised from the scalp, neck, hands, feet, or genitalia. Other anatomic sites use their own excision code families.
Is simple closure separately billable?
Simple closure is included in the excision. A separately performed intermediate or complex repair may be reported when its documentation supports separate reporting.
Can modifier 50 be used for lesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the service according to the applicable lesion and site coding.
What postoperative care is included?
Related postoperative visits during the 10-day global period are included in the procedure payment.
How does CMS handle another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment is statutorily restricted, and co-surgeon and team-surgery payment 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.
1,31611421,,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
1,31911424,,Exc h-f-nk-sp b9+marg 3.1-4,A,,2.42,4.51,,2.15,,0.37,7.30,4.94,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,32011426,,Exc h-f-nk-sp b9+marg >4 cm,A,,3.99,5.55,,2.70,,0.64,10.18,7.33,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,32111440,,Exc face-mm b9+marg 0.5 cm/<,A,,1.02,3.12,,1.80,,0.11,4.25,2.93,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,32211441,,Exc face-mm b9+marg 0.6-1 cm,A,,1.49,3.52,,1.92,,0.19,5.20,3.60,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817