FeeBase
Log inGet started
Menu

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

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 South Carolina, Medicare pays $294.18 for 11604 in the office and $174.13 when it’s performed in a hospital or facility.

$294.18Office (non-facility)
$174.13Hospital or facility
−5.4%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 South Carolina
  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 South Carolina 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. South Carolina pays $294.18. The RVUs are the same everywhere; the geographic indexes change the dollars.

11604 in South Carolina vs other payment areas
  1. South Carolina · this page$294.18
  2. Los Angeles, CA · California$346.28+$52.10
  3. Washington, DC area · District of Columbia$352.65+$58.47
  4. Miami, FL · Florida$339.36+$45.18
  5. Chicago, IL · Illinois$329.96+$35.78
  6. Manhattan, NY · New York$356.89+$62.71
  7. Alaska · Alaska$369.20+$75.02

Other areas in South Carolina 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 South Carolina 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

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Office calculation for 11604 in South Carolina
ComponentRVULocality factorAdjusted
Physician work3.09× 1.0003.0900
Practice expense5.82× 0.9245.3777
Malpractice0.40× 0.8500.3400
Total RVUs8.8077
Conversion factor× 33.4009

Office rate, South Carolina$294.18

Office: (3.09 × 1 + 5.82 × 0.924 + 0.4 × 0.85) × $33.4009 = $294.18

Facility: (3.09 × 1 + 1.93 × 0.924 + 0.4 × 0.85) × $33.4009 = $174.13

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, South Carolina
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.$261.40
11606Lesion excision, trunk or extremity, over 4 cmSame trunk-and-extremity malignant excision family; the excised diameter is greater than 4 cm.$438.71
Used instead
11624Skin excision, 3.1–4 cm excised diameterFor the same size range at the scalp, neck, hands, feet, or genitalia.$321.34
11644Malignant lesion excision, face and related sites, 3.1-4 cmFor the same size range on the face, ears, eyelids, nose, or lips.$372.22
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.$282.75

How 11604 has changed in South Carolina

11604 · Office / nonfacility

$294.18

Effective 2026-10-01

The base rate is $10.47 higher than on 2025-10-01, moving from $283.71 to $294.18 (3.7%).

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

    $283.71changed to$294.18

    • 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
    • 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

    $292.00changed to$283.71

    • 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

    $287.23changed to$292.00

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $294.49changed to$287.23

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.73 changed to 5.76
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.756 changed to 0.817

  5. January 1, 2023

    RVU23A

    $295.57changed to$294.49

    • 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
    • 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

    $298.19changed to$295.57

    • 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

    $298.76changed to$298.19

    • 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
    • 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

    $297.75changed to$298.76

    • 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
    • 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

    $298.61changed to$297.75

    • 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

    $298.09changed to$298.61

    • 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 0.634 changed to 0.553

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $297.92changed to$298.09

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.24 changed to 5.27
    • Malpractice GPCI 0.715 changed to 0.634

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $297.89changed to$297.92

    • 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

    $296.41changed to$297.89

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $291.72changed to$296.41

    • 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 0.911 changed to 0.912
    • Malpractice GPCI 0.618 changed to 0.715

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $294.88changed to$291.72

    • 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 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: $294.88

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$294.18$174.13RVU26D
2026-07-01$294.18$174.13RVU26C
2026-04-01$294.18$174.13RVU26B
2026-01-01$294.18$174.13RVU26A
2025-10-01$283.71$196.89RVU25D
2025-07-01$283.71$196.89RVU25C
2025-04-01$283.71$196.89RVU25B
2025-01-01$283.71$196.89RVU25A
2024-10-01$292.00$200.82RVU24D
2024-07-01$292.00$200.82RVU24C
2024-04-01$292.00$200.82RVU24B
2024-03-09$292.00$200.82RVU24AR
2024-01-01$287.23$197.55RVU24A
2023-10-01$294.49$202.18RVU23D
2023-07-01$294.49$202.18RVU23C
2023-04-01$294.49$202.18RVU23B
2023-01-01$294.49$202.18RVU23A
2022-10-01$295.57$201.82RVU22D
2022-07-01$295.57$201.82RVU22C
2022-04-01$295.57$201.82RVU22B
2022-01-01$295.57$201.82RVU22A
2021-10-01$298.19$202.72RVU21D
2021-07-01$298.19$202.72RVU21C
2021-04-01$298.19$202.72RVU21B
2021-01-01$298.19$202.72RVU21A
2020-10-01$298.76$206.78RVU20D
2020-07-01$298.76$206.78RVU20C
2020-04-01$298.76$206.78RVU20B
2020-01-01$298.76$206.78RVU20A
2019-10-01$297.75$207.04RVU19D
2019-07-01$297.75$207.04RVU19C
2019-04-01$297.75$207.04RVU19B
2019-01-01$297.75$207.04RVU19A
2018-10-01$298.61$207.34RVU18D
2018-07-01$298.61$207.34RVU18C
2018-04-01$298.61$207.34RVU18B
2018-01-01$298.61$207.34RVU18AR1
2017-10-01$298.09$208.41RVU17D
2017-07-01$298.09$208.41RVU17C
2017-04-01$298.09$208.41RVU17B
2017-01-01$298.09$208.41RVU17A
2016-10-01$297.92$208.45RVU16D
2016-07-01$297.92$208.45RVU16C
2016-04-01$297.92$208.45RVU16B
2016-01-01$297.92$208.45RVU16A
2015-10-01$297.89$208.75RVU15D
2015-07-01$297.89$208.75RVU15C
2015-04-01$296.41$207.72RVU15B
2015-01-01$296.41$207.72RVU15A
2014-10-01$291.72$204.58RVU14D
2014-07-01$291.72$204.58RVU14C
2014-04-01$291.72$204.58RVU14B
2014-01-01$291.72$204.58RVU14A
2013-10-01$294.88$200.86RVU13D
2013-07-01$294.88$200.86RVU13C
2013-04-01$294.88$200.86RVU13B
2013-01-01$294.88$200.86RVU13AR

Price 11604 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

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 South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 11604 pays in South Carolina?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 11604 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet