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CPT code 11604: Malignant excision, trunk or extremity, 3.1–4 cm2026 Medicare rate & RVUs in Connecticut

Reports excision of a malignant skin lesion on the trunk or extremity when the lesion and required margins measure 3.1–4 cm across.

CMS RVU26DEffective Oct 1, 2026One payment locality38.3K Medicare services in 2024

In Connecticut, Medicare pays $330.80 for 11604 in the office and $190.87 when it’s performed in a hospital or facility.

$330.80Office (non-facility)
$190.87Hospital or facility
+6.4%vs the national office rate ($310.96)

Check a contract rate as a % of Medicare · 11604 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 11604 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 11604 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 11604 covers

A dermatologist, surgeon, or other qualified practitioner uses this code to remove a malignant skin lesion from the trunk or an arm or leg. The coded size is the greatest diameter of the lesion plus the margins taken for excision—not the length of the resulting wound or closure. The excised tissue is typically submitted for pathologic examination. Simple closure is included in the excision; a separately documented intermediate or complex repair may be reported when performed.

Select the size level using the documented lesion diameter and margins, measured before removal. Record the lesion’s site, clinical size, margins, and excision performed so the reported diameter is supported. CMS assigns a 10-day global period, which includes related postoperative visits during that period. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeons and team surgery 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 Connecticut compares for 11604

Across 109 of 109 payment localities, the office rate for 11604 runs from $277.07 in Arkansas to $402.04 in San Benito County, CA. Connecticut pays $330.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

11604 in Connecticut vs other payment areas
  1. Connecticut · this page$330.80
  2. Los Angeles, CA · California$346.28+$15.48
  3. Washington, DC area · District of Columbia$352.65+$21.85
  4. Miami, FL · Florida$339.36+$8.56
  5. Chicago, IL · Illinois$329.96−$0.84
  6. Manhattan, NY · New York$356.89+$26.09
  7. Alaska · Alaska$369.20+$38.40

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

Every other payment area

11604 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$280.86$167.18
ArkansasArkansas$277.07$165.46
ArizonaArizona$303.01$177.11
Bakersfield, CACalifornia$326.36$183.96
Chico, CACalifornia$325.18$182.78
El Centro, CACalifornia$325.25$182.84
Fresno, CACalifornia$325.18$182.78
Hanford, CACalifornia$325.18$182.78

11604 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$277.07

$369.20

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

View every state and territory as a table
11604 office rate range by state
State / territoryOffice rate rangeLocalities
AK$369.201
AL$280.861
AR$277.071
AZ$303.011
CA$325.18–$402.0429
CO$321.721
CT$330.801
DC$352.651
DE$307.801
FL$309.13–$339.363
GA$292.53–$317.072
GU$331.971
HI$331.971
IA$286.381
ID$288.371
IL$301.57–$329.964
IN$289.901
KS$285.671
KY$288.251
LA$288.05–$301.312
MA$320.20–$351.442
MD$313.23–$352.653
ME$290.36–$304.282
MI$295.77–$313.322
MN$307.191
MO$283.79–$301.663
MS$280.451
MT$310.941
NC$293.111
ND$303.031
NE$287.681
NH$317.261
NJ$334.27–$349.482
NM$297.511
NV$308.931
NY$297.27–$365.765
OH$294.161
OK$287.181
OR$306.22–$330.772
PA$294.29–$323.372
PR$312.901
RI$317.901
SC$294.181
SD$302.091
TN$287.091
TX$292.52–$320.928
UT$297.941
VA$303.73–$352.652
VI$312.901
VT$302.421
WA$319.41–$357.812
WI$293.551
WV$291.261
WY$307.491

See 11604 in every payment locality

How the 11604 rate is calculated

Each of 11604’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 · 11604

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.09

3.09 RVUs× 1.000 GPCI

Practice expense5.82

5.82 RVUs× 1.000 GPCI

Malpractice0.40

0.40 RVUs× 1.000 GPCI

Adjusted RVUs

9.3100

Conversion factor

$33.4009

Medicare rate

$310.96

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,344

Code
11604
Physician work
3.09
Practice expense
5.82
Malpractice
0.40

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 11604 in Connecticut
ComponentRVULocality factorAdjusted
Physician work3.09× 1.0203.1518
Practice expense5.82× 1.0776.2681
Malpractice0.40× 1.2100.4840
Total RVUs9.9039
Conversion factor× 33.4009

Office rate, Connecticut$330.80

Office: (3.09 × 1.02 + 5.82 × 1.077 + 0.4 × 1.21) × $33.4009 = $330.80

Facility: (3.09 × 1.02 + 1.93 × 1.077 + 0.4 × 1.21) × $33.4009 = $190.87

Open 11604 in the RVU calculator

Payment rules and modifiers for 11604

11604 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11604

Malignant excision, trunk or extremity, 3.1–4 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 · 11604

Malignant excision, trunk or extremity, 3.1–4 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

11604 without 51 · national office

$310.96

Malignant excision, trunk or extremity, 3.1–4 cm

11604-51 · Second procedure: 50%

$155.48

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

Codes related to 11604

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 11604
CodeHow it relatesOffice range, Connecticut
Same family
11603Lesion excision, trunk or limb, 2.1–3 cmSame trunk-and-extremity malignant excision family; the excised diameter is 2.1–3 cm.$293.73
11606Lesion excision, trunk or extremity, over 4 cmSame trunk-and-extremity malignant excision family; the excised diameter is greater than 4 cm.$493.72
Used instead
11624Skin excision, 3.1–4 cm excised diameterFor the same size range at the scalp, neck, hands, feet, or genitalia.$360.90
11644Malignant lesion excision, face and related sites, 3.1-4 cmFor the same size range on the face, ears, eyelids, nose, or lips.$417.61
Often billed with
12032Intermediate repair, 2.6–7.5 cm, scalp/trunk/extremitiesMay be separately reported for a qualifying intermediate repair of the trunk or extremity.$319.51

How 11604 has changed in Connecticut

11604 · Office / nonfacility

$330.80

Effective 2026-10-01

The base rate is $6.30 higher than on 2025-10-01, moving from $324.50 to $330.80 (1.9%).

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

    $324.50changed to$330.80

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.17 changed to 3.09
    • Practice expense RVU 5.75 changed to 5.82
    • Malpractice RVU 0.43 changed to 0.40
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $333.90changed to$324.50

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.76 changed to 5.75
    • Malpractice RVU 0.42 changed to 0.43

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $328.45changed to$333.90

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $339.85changed to$328.45

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.73 changed to 5.76
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $344.12changed to$339.85

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.64 changed to 5.73
    • Malpractice RVU 0.40 changed to 0.42
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $347.23changed to$344.12

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.63 changed to 5.64
    • Malpractice RVU 0.42 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $348.81changed to$347.23

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.35 changed to 5.63
    • Malpractice RVU 0.41 changed to 0.42
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $350.86changed to$348.81

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.28 changed to 5.35
    • Malpractice RVU 0.50 changed to 0.41
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $352.12changed to$350.86

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.31 changed to 5.28
    • Malpractice RVU 0.51 changed to 0.50

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $350.86changed to$352.12

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.27 changed to 5.31
    • Malpractice RVU 0.52 changed to 0.51
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $349.48changed to$350.86

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.24 changed to 5.27
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $349.01changed to$349.48

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.23 changed to 5.24
    • Malpractice RVU 0.49 changed to 0.52

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $347.27changed to$349.01

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $343.07changed to$347.27

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.12 changed to 5.23
    • Malpractice RVU 0.50 changed to 0.49
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $349.44changed to$343.07

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.75 changed to 5.12
    • Malpractice RVU 0.52 changed to 0.50
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $349.44

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$330.80$190.87RVU26D
2026-07-01$330.80$190.87RVU26C
2026-04-01$330.80$190.87RVU26B
2026-01-01$330.80$190.87RVU26A
2025-10-01$324.50$220.75RVU25D
2025-07-01$324.50$220.75RVU25C
2025-04-01$324.50$220.75RVU25B
2025-01-01$324.50$220.75RVU25A
2024-10-01$333.90$224.95RVU24D
2024-07-01$333.90$224.95RVU24C
2024-04-01$333.90$224.95RVU24B
2024-03-09$333.90$224.95RVU24AR
2024-01-01$328.45$221.28RVU24A
2023-10-01$339.85$227.82RVU23D
2023-07-01$339.85$227.82RVU23C
2023-04-01$339.85$227.82RVU23B
2023-01-01$339.85$227.82RVU23A
2022-10-01$344.12$228.46RVU22D
2022-07-01$344.12$228.46RVU22C
2022-04-01$344.12$228.46RVU22B
2022-01-01$344.12$228.46RVU22A
2021-10-01$347.23$229.46RVU21D
2021-07-01$347.23$229.46RVU21C
2021-04-01$347.23$229.46RVU21B
2021-01-01$347.23$229.46RVU21A
2020-10-01$348.81$235.94RVU20D
2020-07-01$348.81$235.94RVU20C
2020-04-01$348.81$235.94RVU20B
2020-01-01$348.81$235.94RVU20A
2019-10-01$350.86$240.25RVU19D
2019-07-01$350.86$240.25RVU19C
2019-04-01$350.86$240.25RVU19B
2019-01-01$350.86$240.25RVU19A
2018-10-01$352.12$240.84RVU18D
2018-07-01$352.12$240.84RVU18C
2018-04-01$352.12$240.84RVU18B
2018-01-01$352.12$240.84RVU18AR1
2017-10-01$350.86$241.02RVU17D
2017-07-01$350.86$241.02RVU17C
2017-04-01$350.86$241.02RVU17B
2017-01-01$350.86$241.02RVU17A
2016-10-01$349.48$239.50RVU16D
2016-07-01$349.48$239.50RVU16C
2016-04-01$349.48$239.50RVU16B
2016-01-01$349.48$239.50RVU16A
2015-10-01$349.01$239.44RVU15D
2015-07-01$349.01$239.44RVU15C
2015-04-01$347.27$238.25RVU15B
2015-01-01$347.27$238.25RVU15A
2014-10-01$343.07$236.33RVU14D
2014-07-01$343.07$236.33RVU14C
2014-04-01$343.07$236.33RVU14B
2014-01-01$343.07$236.33RVU14A
2013-10-01$349.44$234.64RVU13D
2013-07-01$349.44$234.64RVU13C
2013-04-01$349.44$234.64RVU13B
2013-01-01$349.44$234.64RVU13AR

Price 11604 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

11604 billing questions

How is the 3.1–4 cm size determined?

Use the greatest diameter of the lesion together with the margins taken for excision. The wound or closure length does not determine the size level.

Can the repair be billed separately?

Simple closure is included in the excision. A separately documented intermediate or complex repair may be reported when performed.

Does the 10-day global include postoperative visits?

Yes. Related postoperative visits during the 10-day global period are included.

Can modifier 50 be used for lesions on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code. When multiple procedures are performed in the same session, the standard multiple-procedure reduction applies.

May an assistant or co-surgeon be reported?

Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted for this code.

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 11604PPRRVU2026_Oct_nonQPP.csv, line 1,344 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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