Billing code 11424: Lesion excisionMedicare rate & RVUs in Washington
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.
Medicare pays $249.91–$279.80 for 11424 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 11424 covers
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.
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 11424 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $249.91 | $166.90 |
| Seattle (King Cnty) | $279.80 | $183.08 |
How the 11424 rate is calculated
Each of 11424’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 · 11424
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.42Practice expense 4.51Malpractice 0.37
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11424
11424 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11424
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 · 11424
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
11424 without 51 · national office
$243.83
Lesion excision
11424-51 · Second procedure: 50%
$121.92
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%).
11424 compared with similar codes
Compare codes
11424 vs 11423 vs 11426 vs 11404 vs 11624: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 11423Skin excision
- 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.
- 11426Benign lesion excision
- Use 11426 when the excised diameter at these sites is greater than 4 cm; 11424 covers 3.1 to 4 cm.
- 11404Skin excision
- The size range is the same, but 11404 applies to trunk and extremity sites rather than scalp, neck, hands, feet, or genitalia.
- 11624Skin excision
- Use 11624 for a malignant lesion excised from these sites in the same size range. Code 11424 is for benign lesions.
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 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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