$151.57–$177.04
Both cover benign lesion excision on the trunk, arms, or legs; choose 11401 when the excised diameter, including margins, is larger than 0.5 cm.
On this page
CMS RVU26D · Effective 2026-10-01
11400 Skin lesion excision Medicare reimbursement rates in Virginia
Excision of a small benign lesion on the trunk, arm, or leg is reported when the lesion and planned margins measure 0.5 cm or less. Compare 11400 office and facility rates across CMS payment localities in Virginia.
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 11400 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$125.23–$146.81
2 of 2 localities have a supported rate.
Facility setting
$74.67–$86.22
2 of 2 localities have a supported rate.
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 11400: Small benign lesion excision, trunk or limb
Excision of a small benign lesion on the trunk, arm, or leg is reported when the lesion and planned margins measure 0.5 cm or less.
A clinician excises a benign skin lesion from the trunk, an arm, or a leg, removing the lesion with the margin needed for complete removal. A small benign nevus is a typical example. Dermatologists, primary care clinicians, and surgeons commonly perform this procedure in an office or outpatient setting. The code is limited to these anatomic areas; lesions on the face, neck, hands, feet, or genitalia follow different site-specific code families.
Choose the code using the excised diameter, including the planned margins, rather than the visible lesion alone. Document the lesion’s site, its size, the margins removed, and the benign clinical indication. Simple closure is included; a separately documented intermediate or complex repair may be reported when supported. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Modifier 50 is inappropriate. Medicare does not pay for an assistant at surgery, and co-surgeon or team-surgery reporting is not permitted.
CMS billing rules for 11400
- 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 RVU0.88 · 23%
- Practice expense (office) RVU2.84 · 74%
- Malpractice RVU0.11 · 3%
14.8K
Medicare services in 2024 · #1259 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.
11400 compared with similar codes
Office rates for Virginia, from the same CMS release.
$122.35–$142.77
Use 11420 for a benign lesion on the scalp, neck, hands, feet, or genitalia. Use 11400 for the trunk, arms, or legs.
$139.10–$162.76
Use 11440 for benign lesion excision on the face. This code is for the trunk, arms, or legs.
$193.99–$226.68
Both involve small lesions on the trunk, arms, or legs, but 11600 is for a malignant lesion; 11400 is for a benign lesion.
Compare 11400 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$146.81
Facility
$86.22
Virginia →
Office / nonfacility
$125.23
Facility
$74.67
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11400 billing questions
How is the size selected?
Use the diameter of the lesion plus the margins removed, measured before excision. This code is for an excised diameter of 0.5 cm or less.
Can this code be used for a lesion on the face or neck?
No. This code is for the trunk, arms, and legs. The 11420 family covers scalp, neck, hands, feet, and genitalia; the 11440 family covers the face.
Is simple closure separately billable?
Simple closure is included in the excision. A separately documented intermediate or complex repair may be reportable when the repair service meets the applicable coding requirements.
What documentation supports reporting this code?
Document the lesion’s benign clinical indication and anatomic site, its size, the margins removed, and the resulting excised diameter. The measurement must support the 0.5 cm-or-less size level.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and applies a 50% reduction to the other procedures in the session. Modifier 50 is inappropriate for this code.
Are assistant or co-surgeon services payable?
Medicare does not pay an assistant-at-surgery claim for this service. Co-surgeon and team-surgery reporting 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.
1,3061135F,,Epsd bk pain for >6 wks,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,3071136F,,Epsd bk pain for 12 wks/<,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,3081137F,,Epsd bk pain for >12 wks,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,30911400,,Exc tr-ext b9+marg 0.5 cm<,A,,0.88,2.84,,1.30,,0.11,3.83,2.29,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31011401,,Exc tr-ext b9+marg 0.6-1 cm,A,,1.25,3.23,,1.42,,0.16,4.64,2.83,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31111402,,Exc tr-ext b9+marg 1.1-2 cm,A,,1.41,3.53,,1.48,,0.18,5.12,3.07,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31211403,,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