CPT 11400Surgery

Exc tr-ext b9+marg 0.5 cm<

CPT 11400 covers the surgical removal of a benign (non-cancerous) skin growth on the trunk, arms, or legs when the lesion plus margin measures 0.5 centimeters or less in diameter. This is the smallest size category for excision of benign lesions on these body areas.

Showing rates for

National Average

Base Medicare rate

$124.21

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.9

PE RVU (NF)

2.81

MP RVU

0.13

Total RVU

3.84

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Measure the lesion plus margin AFTER excision and document the greatest clinical diameter in the operative note. The pathology report diameter alone is insufficient for code selection.
Impact: Correct size documentation prevents downcoding from higher-paying codes. Measuring a 0.6 cm lesion as 0.5 cm costs $34-48 in lost revenue (difference between 11400 and 11401).
Bill in non-facility settings when possible. The site-of-service differential is $41.08 per excision ($124.21 vs $83.13).
Impact: Performing 10 small lesion excisions monthly in office vs hospital outpatient generates an additional $4,929.60 annually in revenue.
When billing multiple excisions, list them in descending RVU order without modifier on the first code, then apply modifier 51 to subsequent codes to maximize reimbursement.
Impact: Proper sequencing ensures the highest-paying procedure receives 100% payment. Incorrect ordering can reduce total payment by 10-25% on multiple-lesion cases.
Use anatomically specific codes rather than 11400 when excising lesions on face, ears, eyelids, nose, lips, or mucous membranes—these use the 11440-11446 series with higher RVUs and reimbursement.
Impact: Facial lesions (11440) pay $185.26 vs $124.21 for 11400—a $61.05 difference per lesion. Incorrect anatomic coding leaves significant money on the table.
Document medical necessity clearly when excising lesions that could be considered cosmetic. Include symptoms (bleeding, irritation, pain), changes in appearance, or diagnostic uncertainty.
Impact: Prevents denials for cosmetic procedures, which are non-covered. A single overturned denial on appeal recovers $124.21 vs writing off the charge.

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Frequently asked questions

What is the CPT code 11400 used for?

CPT 11400 is used for surgical excision of a benign (non-cancerous) skin lesion on the trunk, arms, legs, hands, or feet when the total diameter of the removed tissue (lesion plus margins) measures 0.5 centimeters or less. It includes simple closure but not intermediate or complex repair.

How much does Medicare pay for CPT 11400 in 2025?

Medicare pays $124.21 for CPT 11400 when performed in a non-facility setting (office/clinic) and $83.13 when performed in a facility setting (hospital outpatient department or ASC) based on the 2025 national average rates. Actual payment varies by geographic location due to GPCI adjustments.

How do you measure lesion size for CPT 11400?

Lesion size for 11400 is measured as the greatest clinical diameter of the lesion plus the margin required for complete excision, measured after removal. This should be documented in the operative note in centimeters. The measurement must total 0.5 cm or less; anything larger requires a different code (11401-11406).

What is the difference between CPT 11400 and 11401?

The only difference is lesion size: 11400 is for excised diameter 0.5 cm or less, while 11401 covers 0.6 cm to 1.0 cm. Both are for benign lesions on the same body areas (trunk, arms, legs, hands, feet). CPT 11401 has higher RVUs and pays more: $185.26 non-facility vs $124.21 for 11400.

Can you bill an E/M visit with CPT 11400 on the same day?

Yes, you can bill an E/M service with 11400 on the same day if there is a separately identifiable evaluation and management service beyond the decision for surgery. You must append modifier 25 to the E/M code and document the separate service clearly in the medical record.

What modifier do I use for multiple lesion excisions with 11400?

Use modifier 51 (multiple procedures) on the second and subsequent excision codes when performing multiple lesion removals in the same session. List the highest-RVU procedure first without a modifier, then apply modifier 51 to additional procedures. This typically reduces payment by 50% for secondary procedures.

Does CPT 11400 include pathology?

No, CPT 11400 only covers the surgical excision and simple closure. Pathology examination is billed separately using pathology CPT codes (typically 88305 for skin lesion pathology). The decision to send tissue for pathologic examination should be documented but is billed as a separate service by the pathologist or laboratory.