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CPT code 11626: Skin excision, scalp, neck, hands, feet, genitalia; over 4 cm2026 Medicare rate & RVUs in San Benito County, CA

Excision of a malignant skin lesion on the scalp, neck, hands, feet, or genitalia, with margins producing an excised diameter greater than 4 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality7.2K Medicare services in 2024

In San Benito County, CA, Medicare pays $531.67 for 11626 in the office and $293.74 when it’s performed in a hospital or facility.

$531.67Office (non-facility)
$293.74Hospital or facility
+26.8%vs the national office rate ($419.18)

Check a contract rate as a % of Medicare · 11626 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 11626 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in San Benito County, CA
  2. What 11626 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 11626 covers

This service removes a malignant skin lesion through the dermis, including the margins needed for excision. The site must be the scalp, neck, hand, foot, or genitalia, and the excised diameter must exceed 4 cm. Dermatologists, plastic surgeons, and other clinicians performing skin surgery commonly provide it in office or outpatient settings. Simple closure is included; intermediate or complex repair may be separately reported when performed and documented. The excised tissue is typically submitted for pathologic examination.

Choose the code by the anatomic site and the greatest excised diameter, measured as the lesion plus the margins removed. Document the lesion, site, measurements, margins, and procedure. The 10-day global period includes related postoperative visits during that period. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and reduces the others. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeon and team-surgery billing 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 San Benito County, CA compares for 11626

Across 109 of 109 payment localities, the office rate for 11626 runs from $372.49 in Arkansas to $531.67 in San Benito County, CA. San Benito County, CA pays $531.67. The RVUs are the same everywhere; the geographic indexes change the dollars.

11626 in San Benito County, CA vs other payment areas
  1. San Benito County, CA · this page$531.67
  2. Bakersfield, CA · California$435.51−$96.16
  3. Chico, CA · California$433.36−$98.31
  4. El Centro, CA · California$433.49−$98.18
  5. Fresno, CA · California$433.36−$98.31
  6. Hanford, CA · California$433.36−$98.31
  7. Los Angeles, CA · California$461.42−$70.25

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

Every other payment area

11626 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$433.36$252.52
Merced, CACalifornia$433.36$252.52
Modesto, CACalifornia$433.36$252.52
Napa, CACalifornia$493.68$276.21
Oxnard, CACalifornia$458.19$263.16
Redding, CACalifornia$433.36$252.52
Rest of CaliforniaCalifornia$433.36$252.52
Riverside, CACalifornia$441.56$260.72

11626 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.

$372.49

$498.62

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

View every state and territory as a table
11626 office rate range by state
State / territoryOffice rate rangeLocalities
AK$498.621
AL$377.691
AR$372.491
AZ$407.971
CA$433.36–$531.6729
CO$431.031
CT$446.291
DC$473.551
DE$414.441
FL$421.22–$467.993
GA$397.72–$428.632
GU$441.901
HI$441.901
IA$383.151
ID$386.301
IL$412.26–$454.324
IN$388.331
KS$383.181
KY$389.961
LA$390.08–$408.252
MA$429.35–$469.842
MD$421.53–$473.553
ME$390.08–$407.622
MI$401.24–$428.062
MN$408.381
MO$384.87–$407.533
MS$378.661
MT$419.131
NC$393.681
ND$404.101
NE$384.621
NH$426.011
NJ$450.07–$469.372
NM$404.051
NV$415.191
NY$399.45–$496.625
OH$398.171
OK$387.431
OR$410.67–$442.152
PA$397.79–$436.782
PR$421.481
RI$427.341
SC$396.841
SD$402.331
TN$385.241
TX$395.43–$430.738
UT$401.961
VA$407.57–$473.552
VI$421.481
VT$404.201
WA$427.99–$477.382
WI$391.371
WV$398.181
WY$412.581

See 11626 in every payment locality

How the 11626 rate is calculated

Each of 11626’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 · 11626

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.49

4.49 RVUs× 1.000 GPCI

Practice expense7.30

7.30 RVUs× 1.000 GPCI

Malpractice0.76

0.76 RVUs× 1.000 GPCI

Adjusted RVUs

12.5500

Conversion factor

$33.4009

Medicare rate

$419.18

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

The exact San Benito County, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,352

Code
11626
Physician work
4.49
Practice expense
7.30
Malpractice
0.76

GPCI2026.csv

26

Locality
San Benito County, CA
Physician work
1.110
Practice expense
1.442
Malpractice
0.536
Office calculation for 11626 in San Benito County, CA
ComponentRVULocality factorAdjusted
Physician work4.49× 1.1104.9839
Practice expense7.30× 1.44210.5266
Malpractice0.76× 0.5360.4074
Total RVUs15.9179
Conversion factor× 33.4009

Office rate, San Benito County, CA$531.67

Office: (4.49 × 1.11 + 7.3 × 1.442 + 0.76 × 0.536) × $33.4009 = $531.67

Facility: (4.49 × 1.11 + 2.36 × 1.442 + 0.76 × 0.536) × $33.4009 = $293.74

Open 11626 in the RVU calculator

Payment rules and modifiers for 11626

11626 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11626

Skin excision, scalp, neck, hands, feet, genitalia; 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 · 11626

Skin excision, scalp, neck, hands, feet, genitalia; 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

11626 without 51 · national office

$419.18

Skin excision, scalp, neck, hands, feet, genitalia; over 4 cm

11626-51 · Second procedure: 50%

$209.59

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 11626

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

Codes related to 11626
CodeHow it relatesOffice range, San Benito County, CA
Same family
11624Skin excision, 3.1–4 cm excised diameterSame site group; applies when the excised diameter is 3.1 to 4 cm.$435.68
11621Skin lesion excision, scalp, neck, hands, feet, genitaliaSame site group; applies when the excised diameter is 0.6 to 1 cm.$299.67
Used instead
11606Lesion excision, trunk or extremity, over 4 cmFor a malignant lesion over 4 cm on the trunk, arms, or legs.$588.87
11646Malignant lesion excision, face and related sites, over 4 cmFor a malignant lesion over 4 cm on the face, ears, eyelids, nose, or lips.$646.78

How 11626 has changed in San Benito County, CA

11626 · Office / nonfacility

$531.67

Effective 2026-10-01

The base rate is $36.66 higher than on 2025-10-01, moving from $495.01 to $531.67 (7.4%).

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

    $495.01changed to$531.67

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.61 changed to 4.49
    • Practice expense RVU 6.83 changed to 7.30
    • Malpractice RVU 0.77 changed to 0.76
    • Work GPCI 1.100 changed to 1.110
    • Practice expense GPCI 1.435 changed to 1.442
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $509.41changed to$495.01

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $501.09changed to$509.41

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $512.36changed to$501.09

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.75 changed to 0.77
    • Work GPCI 1.098 changed to 1.100
    • Practice expense GPCI 1.409 changed to 1.435
    • Malpractice GPCI 0.579 changed to 0.560

  5. January 1, 2023

    RVU23A

    $512.65changed to$512.36

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.73 changed to 6.83
    • Malpractice RVU 0.76 changed to 0.75
    • Work GPCI 1.096 changed to 1.098
    • Practice expense GPCI 1.383 changed to 1.409
    • Malpractice GPCI 0.597 changed to 0.579

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $500.25changed to$512.65

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.69 changed to 6.73
    • Malpractice RVU 0.74 changed to 0.76
    • Work GPCI 1.084 changed to 1.096
    • Practice expense GPCI 1.330 changed to 1.383

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $485.10changed to$500.25

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.31 changed to 6.69
    • Work GPCI 1.072 changed to 1.084
    • Practice expense GPCI 1.279 changed to 1.330
    • Malpractice GPCI 0.580 changed to 0.597

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $463.55changed to$485.10

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.23 changed to 6.31
    • Malpractice RVU 0.80 changed to 0.74
    • Work GPCI 1.052 changed to 1.072
    • Practice expense GPCI 1.214 changed to 1.279
    • Malpractice GPCI 0.562 changed to 0.580

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $450.26changed to$463.55

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.22 changed to 6.23
    • Work GPCI 1.041 changed to 1.052
    • Practice expense GPCI 1.167 changed to 1.214

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $437.34changed to$450.26

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.19 changed to 6.22
    • Malpractice RVU 0.81 changed to 0.80
    • Work GPCI 1.031 changed to 1.041
    • Practice expense GPCI 1.121 changed to 1.167
    • Malpractice GPCI 0.610 changed to 0.562

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$437.34

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$531.67$293.74RVU26D
2026-07-01$531.67$293.74RVU26C
2026-04-01$531.67$293.74RVU26B
2026-01-01$531.67$293.74RVU26A
2025-10-01$495.01$334.40RVU25D
2025-07-01$495.01$334.40RVU25C
2025-04-01$495.01$334.40RVU25B
2025-01-01$495.01$334.40RVU25A
2024-10-01$509.41$341.27RVU24D
2024-07-01$509.41$341.27RVU24C
2024-04-01$509.41$341.27RVU24B
2024-03-09$509.41$341.27RVU24AR
2024-01-01$501.09$335.70RVU24A
2023-10-01$512.36$343.81RVU23D
2023-07-01$512.36$343.81RVU23C
2023-04-01$512.36$343.81RVU23B
2023-01-01$512.36$343.81RVU23A
2022-10-01$512.65$344.66RVU22D
2022-07-01$512.65$344.66RVU22C
2022-04-01$512.65$344.66RVU22B
2022-01-01$512.65$344.66RVU22A
2021-10-01$500.25$336.90RVU21D
2021-07-01$500.25$336.90RVU21C
2021-04-01$500.25$336.90RVU21B
2021-01-01$500.25$336.90RVU21A
2020-10-01$485.10$336.47RVU20D
2020-07-01$485.10$336.47RVU20C
2020-04-01$485.10$336.47RVU20B
2020-01-01$485.10$336.47RVU20A
2019-10-01$463.55$325.30RVU19D
2019-07-01$463.55$325.30RVU19C
2019-04-01$463.55$325.30RVU19B
2019-01-01$463.55$325.30RVU19A
2018-10-01$450.26$317.50RVU18D
2018-07-01$450.26$317.50RVU18C
2018-04-01$450.26$317.50RVU18B
2018-01-01$450.26$317.50RVU18AR1
2017-10-01$437.34$312.22RVU17D
2017-07-01$437.34$312.22RVU17C
2017-04-01$437.34$312.22RVU17B
2017-01-01$437.34$312.22RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 11626 for an earlier date of service

Where the San Benito County, CA rate applies

San Benito County, CA is a Medicare payment area, not a city. Our Census mapping connects it to 5 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • 11626 in Aromas · multiple payment areas
  • Hollister
  • Ridgemark
  • San Juan Bautista
  • Tres Pinos

Browse all communities in California

11626 billing questions

How is the greater-than-4-cm size determined?

Use the excised diameter, including the margins removed, rather than the lesion diameter alone. The measurement must be greater than 4 cm.

When is 11624 more appropriate?

Use 11624 for the same site group when the excised diameter is 3.1 to 4 cm. Code 11626 requires a diameter greater than 4 cm.

Is simple closure separately billable?

Simple closure is included in the excision service. A separately performed intermediate or complex repair may be reported when supported by the operative documentation.

Should modifier 50 be used for lesions on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code. Report the excision according to the documented lesion, site, and size.

Are postoperative visits included?

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

Can an assistant surgeon or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing 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 11626PPRRVU2026_Oct_nonQPP.csv, line 1,352 (RVU26D)
Geographic factors for San Benito County, CAGPCI2026.csv, line 26 (RVU26D)

Open CMS sourceHow we calculate rates

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