$463.25–$525.54
Both apply to inguinal hidradenitis excision. Choose 11463 for complex repair and 11462 for simple or intermediate repair.
On this page
CMS RVU26D · Effective 2026-10-01
11463 Hidradenitis excision Medicare reimbursement rates in Washington
Reports excision of hidradenitis-affected skin and subcutaneous tissue in the inguinal region when the wound requires complex repair. Compare 11463 office and facility rates across CMS payment localities in Washington.
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 11463 in Washington?
Washington 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
$590.24–$666.91
2 of 2 localities have a supported rate.
Facility setting
$318.01–$349.70
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.
Dermatologic surgery
About 11463: Inguinal hidradenitis excision with complex repair
Reports excision of hidradenitis-affected skin and subcutaneous tissue in the inguinal region when the wound requires complex repair.
Code 11463 describes surgical removal of affected skin and subcutaneous tissue for hidradenitis in the groin, with complex repair of the resulting wound. A typical case involves chronic, recurrent disease with involved nodules or sinus tracts in the inguinal fold, rather than drainage of a single acute abscess. Dermatologic, general, or plastic surgeons may perform the procedure in an office or outpatient surgical setting.
Select this code when the site is inguinal and the repair meets the complex level; the extent of excision alone does not determine the repair level. Document the location, tissue removed, disease extent, and work supporting complex closure. The repair is included in the code and is not separately reported. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session multiple procedures, the highest-valued procedure is paid in full and others at 50%. Modifier 50 bilateral payment is 150%; assistant-at-surgery payment requires documented medical necessity. Co-surgeons and team surgery are not permitted.
CMS billing rules for 11463
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.32 · 25%
- Practice expense (office) RVU11.99 · 70%
- Malpractice RVU0.88 · 5%
93
Medicare services in 2024 · #4929 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.
11463 compared with similar codes
Office rates for Washington, from the same CMS release.
$589.07–$665.26
Both describe complex-repair hidradenitis excision, but 11451 is for the axillary site; 11463 is for the inguinal site.
$601.20–$677.63
Both describe complex-repair hidradenitis excision, but 11471 is for perianal, perineal, or umbilical sites; 11463 is inguinal.
Compare 11463 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
Rest Of Washington →
Office / nonfacility
$590.24
Facility
$318.01
Seattle (King Cnty) →
Office / nonfacility
$666.91
Facility
$349.70
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11463 billing questions
When should 11463 be chosen over 11462?
Both codes describe inguinal hidradenitis excision. Use 11463 when the wound requires complex repair; use 11462 when the repair is simple or intermediate.
Can the complex repair be billed separately?
No. The complex repair is included in 11463, so do not report a separate repair code for closing the excision wound.
What documentation supports the complex repair level?
Document the inguinal site, the diseased tissue removed, and the closure work that supports a complex repair. The size of the excision by itself does not establish that level.
How is bilateral inguinal treatment reported?
CMS lists bilateral payment with modifier 50 at 150%. Document the treated sides and follow applicable claim-line reporting instructions.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be paid for this procedure?
Assistant-at-surgery payment is allowed only when medical necessity is documented. 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 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.
1,32711450,,Exc skn hdrdnt ax smpl/ntrm,A,,3.14,9.95,,3.77,,0.72,13.81,7.63,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,32811451,,Exc skn hdrdnt ax complex,A,,4.32,11.87,,4.26,,1.00,17.19,9.58,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,32911462,,Exc skn hdrdnt ing smpl/ntrm,A,,2.93,9.89,,3.70,,0.64,13.46,7.27,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,33011463,,Exc skn hdrdnt ing complex,A,,4.32,11.99,,4.25,,0.88,17.19,9.45,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,33111470,,Exc skn h/p/p/u smpl/ntrm,A,,3.65,10.57,,3.97,,0.79,15.01,8.41,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,33211471,,Exc skn h/p/p/u complex,A,,4.77,11.84,,4.24,,0.92,17.53,9.93,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,3331150F,,Doc pt rsk death w/in 1yr,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