CPT code 11446: Skin lesion excision, face, over 4 cm2026 Medicare rate & RVUs in South Carolina

Reports excision of a benign lesion on the face or related facial sites when the lesion and required margins together exceed 4 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality1K Medicare services in 2024

In South Carolina, Medicare pays $378.39 for 11446 in the office and $271.30 when it’s performed in a hospital or facility.

$378.39Office (non-facility)
$271.30Hospital or facility
−5.0%vs the national office rate ($398.47)

Check a contract rate as a % of Medicare · 11446 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 11446 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Carolina
  2. What 11446 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 11446 covers

A clinician surgically removes a benign skin lesion from the face, ear, eyelid, nose, lip, or mucous membrane. Dermatologists, plastic surgeons, and other surgeons may perform the procedure in an office or operating-room setting. The code represents a large excision in these facial locations, not a shave or destruction technique.

Choose the size level using the widest diameter of the lesion plus the margins removed; the combined excised diameter must be greater than 4 cm. Document the site, benign diagnosis, lesion size, and margins so the measured excision size is clear. Simple closure is included; a separately documented intermediate or complex repair may be reported when its criteria are met. Related postoperative visits during the 10-day global period are included. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting are not permitted.

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.

How South Carolina compares for 11446

Across 109 of 109 payment localities, the office rate for 11446 runs from $356.52 in Arkansas to $502.12 in San Benito County, CA. South Carolina pays $378.39. The RVUs are the same everywhere; the geographic indexes change the dollars.

11446 in South Carolina vs other payment areas
  1. South Carolina · this page$378.39
  2. Los Angeles, CA · California$437.41+$59.02
  3. Washington, DC area · District of Columbia$448.54+$70.15
  4. Miami, FL · Florida$442.20+$63.81
  5. Chicago, IL · Illinois$430.08+$51.69
  6. Manhattan, NY · New York$457.34+$78.95
  7. Alaska · Alaska$480.70+$102.31

Other areas in South Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

11446 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$361.18$259.77
ArkansasArkansas$356.52$256.96
ArizonaArizona$388.40$276.09
Bakersfield, CACalifornia$413.63$286.60
Chico, CACalifornia$411.66$284.63
El Centro, CACalifornia$411.77$284.74
Fresno, CACalifornia$411.66$284.63
Hanford, CACalifornia$411.66$284.63

11446 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$356.52

$480.70

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
11446 office rate range by state
State / territoryOffice rate rangeLocalities
AK$480.701
AL$361.181
AR$356.521
AZ$388.401
CA$411.66–$502.1229
CO$409.421
CT$423.271
DC$448.541
DE$394.331
FL$400.24–$442.203
GA$379.13–$407.022
GU$418.971
HI$418.971
IA$366.121
ID$368.951
IL$392.17–$430.084
IN$370.781
KS$366.141
KY$372.181
LA$372.28–$388.612
MA$407.99–$444.962
MD$400.81–$448.543
ME$372.33–$388.122
MI$382.31–$406.372
MN$388.851
MO$367.60–$387.983
MS$362.041
MT$398.431
NC$375.571
ND$384.981
NE$367.451
NH$404.631
NJ$427.12–$444.982
NM$384.821
NV$394.901
NY$380.75–$469.425
OH$379.561
OK$369.931
OR$390.85–$419.522
PA$379.23–$414.672
PR$400.551
RI$406.231
SC$378.391
SD$383.391
TN$367.991
TX$377.11–$408.928
UT$382.991
VA$388.06–$448.542
VI$400.551
VT$385.061
WA$406.71–$451.952
WI$373.541
WV$379.511
WY$392.571

See 11446 in every payment locality

How the 11446 rate is calculated

Each of 11446’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 · 11446

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.68

4.68 RVUs× 1.000 GPCI

Practice expense6.57

6.57 RVUs× 1.000 GPCI

Malpractice0.68

0.68 RVUs× 1.000 GPCI

Adjusted RVUs

11.9300

Conversion factor

$33.4009

Medicare rate

$398.47

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact South Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,326

Code
11446
Physician work
4.68
Practice expense
6.57
Malpractice
0.68

GPCI2026.csv

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Office calculation for 11446 in South Carolina
ComponentRVULocality factorAdjusted
Physician work4.68× 1.0004.6800
Practice expense6.57× 0.9246.0707
Malpractice0.68× 0.8500.5780
Total RVUs11.3287
Conversion factor× 33.4009

Office rate, South Carolina$378.39

Office: (4.68 × 1 + 6.57 × 0.924 + 0.68 × 0.85) × $33.4009 = $378.39

Facility: (4.68 × 1 + 3.1 × 0.924 + 0.68 × 0.85) × $33.4009 = $271.30

Open 11446 in the RVU calculator

Payment rules and modifiers for 11446

11446 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11446

Skin lesion excision, face, over 4 cm

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 11446

Skin lesion excision, face, over 4 cm

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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

11446 without 51 · national office

$398.47

Skin lesion excision, face, over 4 cm

11446-51 · Second procedure: 50%

$199.24

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%).

When to use modifier 51

How 11446 has changed in South Carolina

11446 · Office / nonfacility

$378.39

Effective 2026-10-01

The base rate is $23.27 higher than on 2025-10-01, moving from $355.12 to $378.39 (6.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $355.12changed to$378.39

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.80 changed to 4.68
    • Practice expense RVU 6.15 changed to 6.57
    • Malpractice RVU 0.69 changed to 0.68
    • Practice expense GPCI 0.913 changed to 0.924
    • Malpractice GPCI 0.817 changed to 0.850

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $363.36changed to$355.12

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.09 changed to 6.15
    • Malpractice RVU 0.68 changed to 0.69

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $357.43changed to$363.36

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $364.24changed to$357.43

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.01 changed to 6.09
    • Malpractice RVU 0.65 changed to 0.68
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.756 changed to 0.817
  5. January 1, 2023

    RVU23A

    $370.11changed to$364.24

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.02 changed to 6.01
    • Malpractice RVU 0.66 changed to 0.65
    • Practice expense GPCI 0.903 changed to 0.908
    • Malpractice GPCI 0.695 changed to 0.756

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $372.54changed to$370.11

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.00 changed to 6.02

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $373.81changed to$372.54

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.66 changed to 6.00
    • Malpractice RVU 0.68 changed to 0.66
    • Practice expense GPCI 0.907 changed to 0.903
    • Malpractice GPCI 0.624 changed to 0.695

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $372.06changed to$373.81

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.59 changed to 5.66
    • Malpractice RVU 0.77 changed to 0.68
    • Practice expense GPCI 0.912 changed to 0.907
    • Malpractice GPCI 0.553 changed to 0.624

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $371.00changed to$372.06

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.57 changed to 5.59

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $371.11changed to$371.00

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.54 changed to 5.57
    • Malpractice GPCI 0.634 changed to 0.553

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $371.75changed to$371.11

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.51 changed to 5.54
    • Malpractice RVU 0.78 changed to 0.77
    • Malpractice GPCI 0.715 changed to 0.634

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $372.83changed to$371.75

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.77 changed to 0.78

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $370.98changed to$372.83

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $366.53changed to$370.98

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.44 changed to 5.51
    • Practice expense GPCI 0.911 changed to 0.912
    • Malpractice GPCI 0.618 changed to 0.715

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $362.10changed to$366.53

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.97 changed to 5.44
    • Malpractice RVU 0.80 changed to 0.77
    • Practice expense GPCI 0.909 changed to 0.911
    • Malpractice GPCI 0.520 changed to 0.618

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $362.10

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$378.39$271.30RVU26D
2026-07-01$378.39$271.30RVU26C
2026-04-01$378.39$271.30RVU26B
2026-01-01$378.39$271.30RVU26A
2025-10-01$355.12$296.35RVU25D
2025-07-01$355.12$296.35RVU25C
2025-04-01$355.12$296.35RVU25B
2025-01-01$355.12$296.35RVU25A
2024-10-01$363.36$301.36RVU24D
2024-07-01$363.36$301.36RVU24C
2024-04-01$363.36$301.36RVU24B
2024-03-09$363.36$301.36RVU24AR
2024-01-01$357.43$296.44RVU24A
2023-10-01$364.24$301.16RVU23D
2023-07-01$364.24$301.16RVU23C
2023-04-01$364.24$301.16RVU23B
2023-01-01$364.24$301.16RVU23A
2022-10-01$370.11$304.79RVU22D
2022-07-01$370.11$304.79RVU22C
2022-04-01$370.11$304.79RVU22B
2022-01-01$370.11$304.79RVU22A
2021-10-01$372.54$306.69RVU21D
2021-07-01$372.54$306.69RVU21C
2021-04-01$372.54$306.69RVU21B
2021-01-01$372.54$306.69RVU21A
2020-10-01$373.81$312.28RVU20D
2020-07-01$373.81$312.28RVU20C
2020-04-01$373.81$312.28RVU20B
2020-01-01$373.81$312.28RVU20A
2019-10-01$372.06$311.92RVU19D
2019-07-01$372.06$311.92RVU19C
2019-04-01$372.06$311.92RVU19B
2019-01-01$372.06$311.92RVU19A
2018-10-01$371.00$311.90RVU18D
2018-07-01$371.00$311.90RVU18C
2018-04-01$371.00$311.90RVU18B
2018-01-01$371.00$311.90RVU18AR1
2017-10-01$371.11$313.83RVU17D
2017-07-01$371.11$313.83RVU17C
2017-04-01$371.11$313.83RVU17B
2017-01-01$371.11$313.83RVU17A
2016-10-01$371.75$314.61RVU16D
2016-07-01$371.75$314.61RVU16C
2016-04-01$371.75$314.61RVU16B
2016-01-01$371.75$314.61RVU16A
2015-10-01$372.83$314.83RVU15D
2015-07-01$372.83$314.83RVU15C
2015-04-01$370.98$313.26RVU15B
2015-01-01$370.98$313.26RVU15A
2014-10-01$366.53$310.40RVU14D
2014-07-01$366.53$310.40RVU14C
2014-04-01$366.53$310.40RVU14B
2014-01-01$366.53$310.40RVU14A
2013-10-01$362.10$301.79RVU13D
2013-07-01$362.10$301.79RVU13C
2013-04-01$362.10$301.79RVU13B
2013-01-01$362.10$301.79RVU13AR

Price 11446 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Abney Crossroads
  • Adams Run
  • Aiken
  • Alcolu
  • Allendale
  • Anderson
  • Andrews

Browse all communities in South Carolina

11446 billing questions

How is the size selected for this code?

Use the widest diameter of the lesion plus the margins removed, not the lesion measurement alone. The combined excised diameter must be greater than 4 cm.

When should 11444 be used instead?

Use 11444 for an excision on the same facial sites when the lesion plus margins measures 3.1 to 4 cm. A measurement over 4 cm supports 11446.

Is closure separately billable?

Simple closure is included in the excision. A distinct intermediate or complex repair may be reported separately when performed and supported by the repair documentation.

Can modifier 50 be appended for lesions on both sides?

No. The descriptor and anatomy make modifier 50 inappropriate for this code.

What postoperative care is included?

Related postoperative visits for 10 days are included in the global period. Document and evaluate separate services under the applicable reporting rules.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery 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 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
RVUs for 11446PPRRVU2026_Oct_nonQPP.csv, line 1,326 (RVU26D)
Geographic factors for South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

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