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CPT code 11606: Lesion excision, trunk or extremity, over 4 cm2026 Medicare rate & RVUs in Hawaii, Guam, HI

Excision of a malignant skin lesion on the trunk, arm, or leg is reported when the lesion and required margins produce an excised diameter greater than 4 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality28.7K Medicare services in 2024

In Hawaii, Guam, HI, Medicare pays $489.09 for 11606 in the office and $274.90 when it’s performed in a hospital or facility.

$489.09Office (non-facility)
$274.90Hospital or facility
+5.5%vs the national office rate ($463.60)

Check a contract rate as a % of Medicare · 11606 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 11606 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Hawaii, Guam, HI
  2. What 11606 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 11606 covers

This code covers surgical removal of a malignant skin lesion from the trunk, an arm, or a leg when the excised diameter, including the margins, is greater than 4 cm. Dermatologists, general surgeons, and other qualified physicians may perform the procedure in an office or surgical setting. The removed tissue is typically submitted for pathologic examination; closure is based on the resulting defect and may involve a separate repair service when the closure is intermediate or complex.

Choose the code by the anatomic site and the excised diameter, not the lesion’s appearance alone. Documentation should identify the site and diagnosis, describe the lesion dimensions and margins, and support the final excised diameter. Simple closure is included. A 10-day global period includes related postoperative visits during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery services 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 Hawaii, Guam, HI compares for 11606

Across 109 of 109 payment localities, the office rate for 11606 runs from $411.61 in Arkansas to $588.87 in San Benito County, CA. Hawaii, Guam, HI pays $489.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

11606 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$489.09
  2. Los Angeles, CA · California$510.69+$21.60
  3. Washington, DC area · District of Columbia$524.05+$34.96
  4. Miami, FL · Florida$517.66+$28.57
  5. Chicago, IL · Illinois$502.44+$13.35
  6. Manhattan, NY · New York$534.60+$45.51
  7. Alaska · Alaska$550.37+$61.28

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

Every other payment area

11606 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$417.40$252.57
ArkansasArkansas$411.61$249.79
ArizonaArizona$451.13$268.58
Bakersfield, CACalifornia$481.87$275.40
Chico, CACalifornia$479.50$273.03
El Centro, CACalifornia$479.64$273.17
Fresno, CACalifornia$479.50$273.03
Hanford, CACalifornia$479.50$273.03

11606 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.

$411.61

$550.37

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

View every state and territory as a table
11606 office rate range by state
State / territoryOffice rate rangeLocalities
AK$550.371
AL$417.401
AR$411.611
AZ$451.131
CA$479.50–$588.8729
CO$476.841
CT$493.721
DC$524.051
DE$458.321
FL$465.74–$517.663
GA$439.59–$474.092
GU$489.091
HI$489.091
IA$423.551
ID$427.041
IL$455.72–$502.444
IN$429.311
KS$423.561
KY$431.001
LA$431.12–$451.362
MA$474.95–$520.022
MD$466.20–$524.053
ME$431.22–$450.802
MI$443.54–$473.322
MN$451.751
MO$425.31–$450.593
MS$418.441
MT$463.551
NC$435.241
ND$446.941
NE$425.191
NH$471.261
NJ$497.90–$519.362
NM$446.651
NV$459.191
NY$441.66–$549.555
OH$440.151
OK$428.221
OR$454.18–$489.252
PA$439.74–$483.122
PR$466.181
RI$472.661
SC$438.711
SD$444.971
TN$425.841
TX$437.11–$476.528
UT$444.411
VA$450.73–$524.052
VI$466.181
VT$447.021
WA$473.45–$528.432
WI$432.761
WV$440.041
WY$456.311

See 11606 in every payment locality

How the 11606 rate is calculated

Each of 11606’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 · 11606

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.89

4.89 RVUs× 1.000 GPCI

Practice expense8.15

8.15 RVUs× 1.000 GPCI

Malpractice0.84

0.84 RVUs× 1.000 GPCI

Adjusted RVUs

13.8800

Conversion factor

$33.4009

Medicare rate

$463.60

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

The exact Hawaii, Guam, HI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,345

Code
11606
Physician work
4.89
Practice expense
8.15
Malpractice
0.84

GPCI2026.csv

46

Locality
Hawaii, Guam, HI
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Office calculation for 11606 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work4.89× 1.0004.8900
Practice expense8.15× 1.1379.2666
Malpractice0.84× 0.5790.4864
Total RVUs14.6429
Conversion factor× 33.4009

Office rate, Hawaii, Guam, HI$489.09

Office: (4.89 × 1 + 8.15 × 1.137 + 0.84 × 0.579) × $33.4009 = $489.09

Facility: (4.89 × 1 + 2.51 × 1.137 + 0.84 × 0.579) × $33.4009 = $274.90

Open 11606 in the RVU calculator

Payment rules and modifiers for 11606

11606 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11606

Lesion excision, trunk or extremity, 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 · 11606

Lesion excision, trunk or extremity, 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

11606 without 51 · national office

$463.60

Lesion excision, trunk or extremity, over 4 cm

11606-51 · Second procedure: 50%

$231.80

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 11606

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

Codes related to 11606
CodeHow it relatesOffice range, Hawaii, Guam, HI
Same family
11604Malignant excision, trunk or extremity, 3.1–4 cmSame site group, for an excised diameter of 3.1–4 cm.$331.97
11626Skin excision, scalp, neck, hands, feet, genitalia; over 4 cmSame greater-than-4-cm size category, for scalp, neck, hands, feet, or genitalia.$441.90
11646Malignant lesion excision, face and related sites, over 4 cmSame greater-than-4-cm size category, for the face, ears, eyelids, nose, or lips.$540.36
Often billed with
88305Tissue pathology exam, level IV specimenMay represent pathologic examination of the excised skin specimen.$76.04
12032Intermediate repair, 2.6–7.5 cm, scalp/trunk/extremitiesMay describe a separately reportable intermediate repair when the repair performed meets its requirements.$324.93

How 11606 has changed in Hawaii, Guam, HI

11606 · Office / nonfacility

$489.09

Effective 2026-10-01

The base rate is $28.45 higher than on 2025-10-01, moving from $460.64 to $489.09 (6.2%).

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

    $460.64changed to$489.09

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.02 changed to 4.89
    • Practice expense RVU 7.61 changed to 8.15
    • Malpractice RVU 0.85 changed to 0.84
    • Practice expense GPCI 1.149 changed to 1.137
    • Malpractice GPCI 0.561 changed to 0.579

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $474.03changed to$460.64

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.60 changed to 7.61
    • Malpractice RVU 0.87 changed to 0.85

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $466.29changed to$474.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $481.21changed to$466.29

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.55 changed to 7.60
    • Malpractice RVU 0.83 changed to 0.87
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 1.146 changed to 1.149
    • Malpractice GPCI 0.618 changed to 0.561

  5. January 1, 2023

    RVU23A

    $488.58changed to$481.21

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.42 changed to 7.55
    • Malpractice RVU 0.84 changed to 0.83
    • Work GPCI 1.010 changed to 1.003
    • Practice expense GPCI 1.143 changed to 1.146
    • Malpractice GPCI 0.675 changed to 0.618

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $490.02changed to$488.58

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.39 changed to 7.42
    • Malpractice RVU 0.78 changed to 0.84

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $489.62changed to$490.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.00 changed to 7.39
    • Malpractice RVU 0.79 changed to 0.78
    • Work GPCI 1.006 changed to 1.010
    • Practice expense GPCI 1.144 changed to 1.143
    • Malpractice GPCI 0.644 changed to 0.675

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $487.23changed to$489.62

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.93 changed to 7.00
    • Malpractice RVU 0.90 changed to 0.79
    • Work GPCI 1.001 changed to 1.006
    • Practice expense GPCI 1.146 changed to 1.144
    • Malpractice GPCI 0.614 changed to 0.644

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $487.30changed to$487.23

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.95 changed to 6.93
    • Malpractice RVU 0.89 changed to 0.90

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $486.19changed to$487.30

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.90 changed to 6.95
    • Malpractice RVU 0.90 changed to 0.89
    • Work GPCI 1.002 changed to 1.001
    • Practice expense GPCI 1.154 changed to 1.146
    • Malpractice GPCI 0.616 changed to 0.614

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $486.24changed to$486.19

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.87 changed to 6.90
    • Malpractice RVU 0.91 changed to 0.90
    • Work GPCI 1.003 changed to 1.002
    • Practice expense GPCI 1.162 changed to 1.154
    • Malpractice GPCI 0.618 changed to 0.616

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $486.88changed to$486.24

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.86 changed to 0.91

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $484.46changed to$486.88

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $479.61changed to$484.46

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.74 changed to 6.87
    • Malpractice RVU 0.84 changed to 0.86
    • Work GPCI 1.002 changed to 1.003
    • Practice expense GPCI 1.158 changed to 1.162
    • Malpractice GPCI 0.659 changed to 0.618

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $488.58changed to$479.61

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.56 changed to 6.74
    • Malpractice RVU 0.88 changed to 0.84
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.700 changed to 0.659

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$488.58

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$489.09$274.90RVU26D
2026-07-01$489.09$274.90RVU26C
2026-04-01$489.09$274.90RVU26B
2026-01-01$489.09$274.90RVU26A
2025-10-01$460.64$312.72RVU25D
2025-07-01$460.64$312.72RVU25C
2025-04-01$460.64$312.72RVU25B
2025-01-01$460.64$312.72RVU25A
2024-10-01$474.03$319.89RVU24D
2024-07-01$474.03$319.89RVU24C
2024-04-01$474.03$319.89RVU24B
2024-03-09$474.03$319.89RVU24AR
2024-01-01$466.29$314.67RVU24A
2023-10-01$481.21$325.48RVU23D
2023-07-01$481.21$325.48RVU23C
2023-04-01$481.21$325.48RVU23B
2023-01-01$481.21$325.48RVU23A
2022-10-01$488.58$331.94RVU22D
2022-07-01$488.58$331.94RVU22C
2022-04-01$488.58$331.94RVU22B
2022-01-01$488.58$331.94RVU22A
2021-10-01$490.02$332.08RVU21D
2021-07-01$490.02$332.08RVU21C
2021-04-01$490.02$332.08RVU21B
2021-01-01$490.02$332.08RVU21A
2020-10-01$489.62$338.51RVU20D
2020-07-01$489.62$338.51RVU20C
2020-04-01$489.62$338.51RVU20B
2020-01-01$489.62$338.51RVU20A
2019-10-01$487.23$338.13RVU19D
2019-07-01$487.23$338.13RVU19C
2019-04-01$487.23$338.13RVU19B
2019-01-01$487.23$338.13RVU19A
2018-10-01$487.30$337.95RVU18D
2018-07-01$487.30$337.95RVU18C
2018-04-01$487.30$337.95RVU18B
2018-01-01$487.30$337.95RVU18AR1
2017-10-01$486.19$337.92RVU17D
2017-07-01$486.19$337.92RVU17C
2017-04-01$486.19$337.92RVU17B
2017-01-01$486.19$337.92RVU17A
2016-10-01$486.24$337.29RVU16D
2016-07-01$486.24$337.29RVU16C
2016-04-01$486.24$337.29RVU16B
2016-01-01$486.24$337.29RVU16A
2015-10-01$486.88$336.98RVU15D
2015-07-01$486.88$336.98RVU15C
2015-04-01$484.46$335.30RVU15B
2015-01-01$484.46$335.30RVU15A
2014-10-01$479.61$334.84RVU14D
2014-07-01$479.61$334.84RVU14C
2014-04-01$479.61$334.84RVU14B
2014-01-01$479.61$334.84RVU14A
2013-10-01$488.58$331.92RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 11606 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

  • Ahuimanu
  • Aiea
  • Ainaloa
  • Anahola
  • Black Sands
  • Captain Cook
  • Discovery Harbour
  • East Honolulu

Browse all communities in Hawaii

11606 billing questions

How is the size threshold determined?

Use the excised diameter, including the margins, rather than the lesion diameter alone. This code applies when that measurement is greater than 4 cm.

When should 11604 be used instead?

Use 11604 for a malignant lesion on the trunk, arm, or leg with an excised diameter of 3.1–4 cm. The site is the same; the size category differs.

Is closure separately reportable?

Simple closure is included in the excision. An intermediate or complex repair may be separately reported when the repair performed and its documentation support that service.

Can modifier 50 be used for lesions on both sides?

No. Modifier 50 is inappropriate for this code. Follow the applicable reporting rules for each procedure performed.

What postoperative care is included?

Related postoperative visits during the 10-day global period are included in the procedure payment.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment is restricted; co-surgeons and team surgery 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 11606PPRRVU2026_Oct_nonQPP.csv, line 1,345 (RVU26D)
Geographic factors for Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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