CPT code 11604: Malignant excision, trunk or extremity, 3.1–4 cm2026 Medicare rate & RVUs in Missouri
Reports excision of a malignant skin lesion on the trunk or extremity when the lesion and required margins measure 3.1–4 cm across.
Medicare pays $283.79–$301.66 for 11604 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. 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.
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On this page 9 sections
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.
Where 11604 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$283.79 to $301.66
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $298.80 | $176.79 |
| Metropolitan St. Louis, MO | $301.66 | $177.97 |
| Rest of Missouri | $283.79 | $171.79 |
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
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.
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
| 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 · 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.
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%).
11604 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 11603Lesion excisionTrunk or limb, 2.1–3 cm
- Use 11603 when the lesion plus margins measures 2.1–3 cm; use 11604 when that diameter measures 3.1–4 cm.
- 11606Lesion excisionTrunk or extremity, over 4 cm
- Use 11606 for a trunk or extremity excision diameter greater than 4 cm. A diameter from 3.1 through 4 cm falls under 11604.
- 11624Skin excision3.1–4 cm excised diameter
- The size range is the same, but 11624 is for the scalp, neck, hands, feet, or genitalia rather than the trunk or extremities.
- 11404Skin excisionTrunk or extremity, 3.1–4 cm
- 11404 is for excision of a benign lesion on the trunk or extremity in the same size range. Code 11604 is for a malignant lesion.
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
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