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

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 Queens, NY, Medicare pays $358.85 for 11604 in the office and $205.28 when it’s performed in a hospital or facility.

$358.85Office (non-facility)
$205.28Hospital or facility
+15.4%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $358.85. The RVUs are the same everywhere; the geographic indexes change the dollars.

11604 in Queens, NY vs other payment areas
  1. Queens, NY · this page$358.85
  2. Manhattan, NY · New York$356.89−$1.96
  3. NYC suburbs and Long Island, NY · New York$365.76+$6.91
  4. Poughkeepsie and northern NYC suburbs, NY · New York$336.88−$21.97
  5. Rest of New York · New York$297.27−$61.58
  6. Los Angeles, CA · California$346.28−$12.57
  7. Washington, DC area · District of Columbia$352.65−$6.20

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

Every other payment area

11604 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$339.36$204.10
Chicago, ILIllinois$329.96$199.38
AlaskaAlaska$369.20$230.83
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

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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 11604 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work3.09× 1.0643.2878
Practice expense5.82× 1.1826.8792
Malpractice0.40× 1.4420.5768
Total RVUs10.7438
Conversion factor× 33.4009

Office rate, Queens, NY$358.85

Office: (3.09 × 1.064 + 5.82 × 1.182 + 0.4 × 1.442) × $33.4009 = $358.85

Facility: (3.09 × 1.064 + 1.93 × 1.182 + 0.4 × 1.442) × $33.4009 = $205.28

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, Queens, NY
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.$318.53
11606Lesion excision, trunk or extremity, over 4 cmSame trunk-and-extremity malignant excision family; the excised diameter is greater than 4 cm.$536.00
Used instead
11624Skin excision, 3.1–4 cm excised diameterFor the same size range at the scalp, neck, hands, feet, or genitalia.$391.37
11644Malignant lesion excision, face and related sites, 3.1-4 cmFor the same size range on the face, ears, eyelids, nose, or lips.$452.74
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.$347.09

How 11604 has changed in Queens, NY

11604 · Office / nonfacility

$358.85

Effective 2026-10-01

The base rate is $7.05 higher than on 2025-10-01, moving from $351.80 to $358.85 (2.0%).

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

    $351.80changed to$358.85

    • 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 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $361.94changed to$351.80

    • 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

    $356.04changed to$361.94

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $378.65changed to$356.04

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.73 changed to 5.76
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $392.36changed to$378.65

    • 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 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $397.04changed to$392.36

    • 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

    $390.36changed to$397.04

    • 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 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $386.75changed to$390.36

    • 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 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $388.38changed to$386.75

    • 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

    $386.79changed to$388.38

    • 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
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $384.96changed to$386.79

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.24 changed to 5.27
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $383.56changed to$384.96

    • 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

    $381.66changed to$383.56

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $372.46changed to$381.66

    • 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
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $374.70changed to$372.46

    • 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
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $374.70

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$358.85$205.28RVU26D
2026-07-01$358.85$205.28RVU26C
2026-04-01$358.85$205.28RVU26B
2026-01-01$358.85$205.28RVU26A
2025-10-01$351.80$238.16RVU25D
2025-07-01$351.80$238.16RVU25C
2025-04-01$351.80$238.16RVU25B
2025-01-01$351.80$238.16RVU25A
2024-10-01$361.94$242.61RVU24D
2024-07-01$361.94$242.61RVU24C
2024-04-01$361.94$242.61RVU24B
2024-03-09$361.94$242.61RVU24AR
2024-01-01$356.04$238.65RVU24A
2023-10-01$378.65$255.43RVU23D
2023-07-01$378.65$255.43RVU23C
2023-04-01$378.65$255.43RVU23B
2023-01-01$378.65$255.43RVU23A
2022-10-01$392.36$264.87RVU22D
2022-07-01$392.36$264.87RVU22C
2022-04-01$392.36$264.87RVU22B
2022-01-01$392.36$264.87RVU22A
2021-10-01$397.04$267.21RVU21D
2021-07-01$397.04$267.21RVU21C
2021-04-01$397.04$267.21RVU21B
2021-01-01$397.04$267.21RVU21A
2020-10-01$390.36$267.25RVU20D
2020-07-01$390.36$267.25RVU20C
2020-04-01$390.36$267.25RVU20B
2020-01-01$390.36$267.25RVU20A
2019-10-01$386.75$267.39RVU19D
2019-07-01$386.75$267.39RVU19C
2019-04-01$386.75$267.39RVU19B
2019-01-01$386.75$267.39RVU19A
2018-10-01$388.38$268.29RVU18D
2018-07-01$388.38$268.29RVU18C
2018-04-01$388.38$268.29RVU18B
2018-01-01$388.38$268.29RVU18AR1
2017-10-01$386.79$268.78RVU17D
2017-07-01$386.79$268.78RVU17C
2017-04-01$386.79$268.78RVU17B
2017-01-01$386.79$268.78RVU17A
2016-10-01$384.96$267.33RVU16D
2016-07-01$384.96$267.33RVU16C
2016-04-01$384.96$267.33RVU16B
2016-01-01$384.96$267.33RVU16A
2015-10-01$383.56$266.38RVU15D
2015-07-01$383.56$266.38RVU15C
2015-04-01$381.66$265.05RVU15B
2015-01-01$381.66$265.05RVU15A
2014-10-01$372.46$257.97RVU14D
2014-07-01$372.46$257.97RVU14C
2014-04-01$372.46$257.97RVU14B
2014-01-01$372.46$257.97RVU14A
2013-10-01$374.70$251.10RVU13D
2013-07-01$374.70$251.10RVU13C
2013-04-01$374.70$251.10RVU13B
2013-01-01$374.70$251.10RVU13AR

Price 11604 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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