CPT code 11626: Skin excision, scalp, neck, hands, feet, genitalia; over 4 cm2026 Medicare rate & RVUs in Metropolitan Boston, MA
Excision of a malignant skin lesion on the scalp, neck, hands, feet, or genitalia, with margins producing an excised diameter greater than 4 cm.
In Metropolitan Boston, MA, Medicare pays $469.84 for 11626 in the office and $272.83 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Metropolitan Boston, MA 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. Metropolitan Boston, MA pays $469.84. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Metropolitan Boston, MA · this page$469.84
- Rest of Massachusetts · Massachusetts$429.35−$40.49
- Los Angeles, CA · California$461.42−$8.42
- Washington, DC area · District of Columbia$473.55+$3.71
- Miami, FL · Florida$467.99−$1.85
- Chicago, IL · Illinois$454.32−$15.52
- Manhattan, NY · New York$483.15+$13.31
Other areas in Massachusetts first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlaskaAlaska | $498.62 | $322.89 |
| AlabamaAlabama | $377.69 | $233.31 |
| ArkansasArkansas | $372.49 | $230.75 |
| ArizonaArizona | $407.97 | $248.08 |
| Bakersfield, CACalifornia | $435.51 | $254.67 |
| Chico, CACalifornia | $433.36 | $252.52 |
| El Centro, CACalifornia | $433.49 | $252.65 |
| Fresno, CACalifornia | $433.36 | $252.52 |
| Hanford, CACalifornia | $433.36 | $252.52 |
| 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 |
| Sacramento, CACalifornia | $452.55 | $260.65 |
| Salinas, CACalifornia | $450.82 | $259.58 |
| San Diego, CACalifornia | $459.84 | $262.50 |
| Marin County, CACalifornia | $519.66 | $287.01 |
| San Francisco, CACalifornia | $518.80 | $286.15 |
| San Benito County, CACalifornia | $531.67 | $293.74 |
| Santa Clara County, CACalifornia | $528.14 | $290.21 |
| San Luis Obispo, CACalifornia | $443.84 | $255.91 |
| Santa Cruz, CACalifornia | $462.97 | $262.50 |
| Santa Maria, CACalifornia | $452.08 | $259.69 |
| Santa Rosa, CACalifornia | $467.49 | $264.87 |
| Stockton, CACalifornia | $433.36 | $252.52 |
| Vallejo, CACalifornia | $492.43 | $274.96 |
| Visalia, CACalifornia | $433.36 | $252.52 |
| Yuba City, CACalifornia | $433.36 | $252.52 |
| ColoradoColorado | $431.03 | $255.47 |
| ConnecticutConnecticut | $446.29 | $268.58 |
| DelawareDelaware | $414.44 | $251.42 |
| Fort Lauderdale, FLFlorida | $442.86 | $275.72 |
| Rest of FloridaFlorida | $421.22 | $263.48 |
| Atlanta, GAGeorgia | $428.63 | $260.99 |
| Rest of GeorgiaGeorgia | $397.72 | $250.54 |
| Hawaii, Guam, HIHawaii | $441.90 | $254.29 |
| IowaIowa | $383.15 | $232.17 |
| IdahoIdaho | $386.30 | $234.50 |
| East St. Louis, ILIllinois | $425.42 | $273.61 |
| Rest of IllinoisIllinois | $412.26 | $261.61 |
| Suburban Chicago, ILIllinois | $446.41 | $276.96 |
| IndianaIndiana | $388.33 | $235.38 |
| KansasKansas | $383.18 | $234.02 |
| KentuckyKentucky | $389.96 | $243.27 |
| New Orleans, LALouisiana | $408.25 | $252.98 |
| Rest of LouisianaLouisiana | $390.08 | $244.05 |
| Baltimore area, MDMaryland | $445.40 | $268.35 |
| Rest of MarylandMaryland | $421.53 | $254.54 |
| Rest of MaineMaine | $390.08 | $238.28 |
| Southern Maine, MEMaine | $407.62 | $244.10 |
| Detroit, MIMichigan | $428.06 | $268.84 |
| Rest of MichiganMichigan | $401.24 | $250.60 |
| MinnesotaMinnesota | $408.38 | $238.60 |
| Metropolitan Kansas City, MOMissouri | $403.72 | $248.79 |
| Metropolitan St. Louis, MOMissouri | $407.53 | $250.45 |
| Rest of MissouriMissouri | $384.87 | $242.64 |
| MississippiMississippi | $378.66 | $236.60 |
| MontanaMontana | $419.13 | $254.13 |
| North CarolinaNorth Carolina | $393.68 | $239.74 |
| North DakotaNorth Dakota | $404.10 | $239.10 |
| NebraskaNebraska | $384.62 | $232.32 |
| New HampshireNew Hampshire | $426.01 | $254.24 |
| Northern New JerseyNew Jersey | $469.37 | $277.97 |
| Rest of New JerseyNew Jersey | $450.07 | $269.89 |
| New MexicoNew Mexico | $404.05 | $252.74 |
| NevadaNevada | $415.19 | $250.02 |
| NYC suburbs and Long Island, NYNew York | $496.62 | $300.43 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $454.42 | $273.75 |
| Queens, NYNew York | $484.38 | $289.35 |
| Rest of New YorkNew York | $399.45 | $242.70 |
| OhioOhio | $398.17 | $247.53 |
| OklahomaOklahoma | $387.43 | $240.09 |
| Portland, OROregon | $442.15 | $258.83 |
| Rest of OregonOregon | $410.67 | $246.33 |
| Metropolitan Philadelphia, PAPennsylvania | $436.78 | $265.01 |
| Rest of PennsylvaniaPennsylvania | $397.79 | $246.32 |
| Puerto RicoPuerto Rico | $421.48 | $254.67 |
| Rhode IslandRhode Island | $427.34 | $256.89 |
| South CarolinaSouth Carolina | $396.84 | $244.38 |
| South DakotaSouth Dakota | $402.33 | $237.33 |
| TennesseeTennessee | $385.24 | $235.25 |
| Austin, TXTexas | $430.73 | $256.16 |
| Beaumont, TXTexas | $395.43 | $245.28 |
| Brazoria, TXTexas | $412.60 | $249.09 |
| Dallas, TXTexas | $415.95 | $251.61 |
| Fort Worth, TXTexas | $413.84 | $251.15 |
| Galveston, TXTexas | $414.31 | $250.46 |
| Houston, TXTexas | $428.22 | $264.37 |
| Rest of TexasTexas | $404.28 | $247.70 |
| UtahUtah | $401.96 | $246.86 |
| VirginiaVirginia | $407.57 | $245.38 |
| Virgin Islands, VIUnited States Virgin Islands | $421.48 | $254.67 |
| VermontVermont | $404.20 | $240.85 |
| Rest of WashingtonWashington | $427.99 | $254.24 |
| King County, WAWashington | $477.38 | $274.93 |
| WisconsinWisconsin | $391.37 | $233.30 |
| West VirginiaWest Virginia | $398.18 | $254.80 |
| WyomingWyoming | $412.58 | $247.58 |
11626 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $498.62 | 1 |
| AL | $377.69 | 1 |
| AR | $372.49 | 1 |
| AZ | $407.97 | 1 |
| CA | $433.36–$531.67 | 29 |
| CO | $431.03 | 1 |
| CT | $446.29 | 1 |
| DC | $473.55 | 1 |
| DE | $414.44 | 1 |
| FL | $421.22–$467.99 | 3 |
| GA | $397.72–$428.63 | 2 |
| GU | $441.90 | 1 |
| HI | $441.90 | 1 |
| IA | $383.15 | 1 |
| ID | $386.30 | 1 |
| IL | $412.26–$454.32 | 4 |
| IN | $388.33 | 1 |
| KS | $383.18 | 1 |
| KY | $389.96 | 1 |
| LA | $390.08–$408.25 | 2 |
| MA | $429.35–$469.84 | 2 |
| MD | $421.53–$473.55 | 3 |
| ME | $390.08–$407.62 | 2 |
| MI | $401.24–$428.06 | 2 |
| MN | $408.38 | 1 |
| MO | $384.87–$407.53 | 3 |
| MS | $378.66 | 1 |
| MT | $419.13 | 1 |
| NC | $393.68 | 1 |
| ND | $404.10 | 1 |
| NE | $384.62 | 1 |
| NH | $426.01 | 1 |
| NJ | $450.07–$469.37 | 2 |
| NM | $404.05 | 1 |
| NV | $415.19 | 1 |
| NY | $399.45–$496.62 | 5 |
| OH | $398.17 | 1 |
| OK | $387.43 | 1 |
| OR | $410.67–$442.15 | 2 |
| PA | $397.79–$436.78 | 2 |
| PR | $421.48 | 1 |
| RI | $427.34 | 1 |
| SC | $396.84 | 1 |
| SD | $402.33 | 1 |
| TN | $385.24 | 1 |
| TX | $395.43–$430.73 | 8 |
| UT | $401.96 | 1 |
| VA | $407.57–$473.55 | 2 |
| VI | $421.48 | 1 |
| VT | $404.20 | 1 |
| WA | $427.99–$477.38 | 2 |
| WI | $391.37 | 1 |
| WV | $398.18 | 1 |
| WY | $412.58 | 1 |
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
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 Metropolitan Boston, MA 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
62
- Locality
- Metropolitan Boston, MA
- Physician work
- 1.041
- Practice expense
- 1.194
- Malpractice
- 0.890
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.49 | × 1.041 | 4.6741 |
| Practice expense | 7.30 | × 1.194 | 8.7162 |
| Malpractice | 0.76 | × 0.890 | 0.6764 |
| Total RVUs | 14.0667 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Metropolitan Boston, MA$469.84
Office: (4.49 × 1.041 + 7.3 × 1.194 + 0.76 × 0.89) × $33.4009 = $469.84
Facility: (4.49 × 1.041 + 2.36 × 1.194 + 0.76 × 0.89) × $33.4009 = $272.83
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
| 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 · 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.
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%).
How 11626 has changed in Metropolitan Boston, MA
11626 · Office / nonfacility
$469.84
Effective 2026-10-01
The base rate is $27.74 higher than on 2025-10-01, moving from $442.10 to $469.84 (6.3%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$442.10changed to$469.84
- 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 1.042 changed to 1.041
- Practice expense GPCI 1.197 changed to 1.194
- Malpractice GPCI 0.894 changed to 0.890
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$454.96changed to$442.10
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$447.53changed to$454.96
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$463.05changed to$447.53
- Conversion factor 33.8872 changed to 32.7442
- Malpractice RVU 0.75 changed to 0.77
- Work GPCI 1.045 changed to 1.042
- Practice expense GPCI 1.200 changed to 1.197
- Malpractice GPCI 0.868 changed to 0.894
January 1, 2023
RVU23A
$469.68changed to$463.05
- 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 1.049 changed to 1.045
- Practice expense GPCI 1.203 changed to 1.200
- Malpractice GPCI 0.842 changed to 0.868
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$471.30changed to$469.68
- 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
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$469.84changed to$471.30
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 6.31 changed to 6.69
- Work GPCI 1.041 changed to 1.049
- Practice expense GPCI 1.191 changed to 1.203
- Malpractice GPCI 0.952 changed to 0.842
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$466.93changed to$469.84
- 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 1.033 changed to 1.041
- Practice expense GPCI 1.179 changed to 1.191
- Malpractice GPCI 1.061 changed to 0.952
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$465.99changed to$466.93
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 6.22 changed to 6.23
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$454.11changed to$465.99
- 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 1.025 changed to 1.033
- Practice expense GPCI 1.171 changed to 1.179
- Malpractice GPCI 0.839 changed to 1.061
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$442.90changed to$454.11
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 6.17 changed to 6.19
- Malpractice RVU 0.82 changed to 0.81
- Work GPCI 1.017 changed to 1.025
- Practice expense GPCI 1.163 changed to 1.171
- Malpractice GPCI 0.617 changed to 0.839
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$443.83changed to$442.90
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.79 changed to 0.82
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$441.62changed to$443.83
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$439.40changed to$441.62
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 6.09 changed to 6.17
- Malpractice RVU 0.77 changed to 0.79
- Work GPCI 1.016 changed to 1.017
- Practice expense GPCI 1.156 changed to 1.163
- Malpractice GPCI 0.704 changed to 0.617
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$439.40
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $469.84 | $272.83 | RVU26D |
| 2026-07-01 | $469.84 | $272.83 | RVU26C |
| 2026-04-01 | $469.84 | $272.83 | RVU26B |
| 2026-01-01 | $469.84 | $272.83 | RVU26A |
| 2025-10-01 | $442.10 | $308.13 | RVU25D |
| 2025-07-01 | $442.10 | $308.13 | RVU25C |
| 2025-04-01 | $442.10 | $308.13 | RVU25B |
| 2025-01-01 | $442.10 | $308.13 | RVU25A |
| 2024-10-01 | $454.96 | $314.70 | RVU24D |
| 2024-07-01 | $454.96 | $314.70 | RVU24C |
| 2024-04-01 | $454.96 | $314.70 | RVU24B |
| 2024-03-09 | $454.96 | $314.70 | RVU24AR |
| 2024-01-01 | $447.53 | $309.57 | RVU24A |
| 2023-10-01 | $463.05 | $319.50 | RVU23D |
| 2023-07-01 | $463.05 | $319.50 | RVU23C |
| 2023-04-01 | $463.05 | $319.50 | RVU23B |
| 2023-01-01 | $463.05 | $319.50 | RVU23A |
| 2022-10-01 | $469.68 | $323.55 | RVU22D |
| 2022-07-01 | $469.68 | $323.55 | RVU22C |
| 2022-04-01 | $469.68 | $323.55 | RVU22B |
| 2022-01-01 | $469.68 | $323.55 | RVU22A |
| 2021-10-01 | $471.30 | $323.55 | RVU21D |
| 2021-07-01 | $471.30 | $323.55 | RVU21C |
| 2021-04-01 | $471.30 | $323.55 | RVU21B |
| 2021-01-01 | $471.30 | $323.55 | RVU21A |
| 2020-10-01 | $469.84 | $331.44 | RVU20D |
| 2020-07-01 | $469.84 | $331.44 | RVU20C |
| 2020-04-01 | $469.84 | $331.44 | RVU20B |
| 2020-01-01 | $469.84 | $331.44 | RVU20A |
| 2019-10-01 | $466.93 | $332.66 | RVU19D |
| 2019-07-01 | $466.93 | $332.66 | RVU19C |
| 2019-04-01 | $466.93 | $332.66 | RVU19B |
| 2019-01-01 | $466.93 | $332.66 | RVU19A |
| 2018-10-01 | $465.99 | $331.87 | RVU18D |
| 2018-07-01 | $465.99 | $331.87 | RVU18C |
| 2018-04-01 | $465.99 | $331.87 | RVU18B |
| 2018-01-01 | $465.99 | $331.87 | RVU18AR1 |
| 2017-10-01 | $454.11 | $323.41 | RVU17D |
| 2017-07-01 | $454.11 | $323.41 | RVU17C |
| 2017-04-01 | $454.11 | $323.41 | RVU17B |
| 2017-01-01 | $454.11 | $323.41 | RVU17A |
| 2016-10-01 | $442.90 | $313.40 | RVU16D |
| 2016-07-01 | $442.90 | $313.40 | RVU16C |
| 2016-04-01 | $442.90 | $313.40 | RVU16B |
| 2016-01-01 | $442.90 | $313.40 | RVU16A |
| 2015-10-01 | $443.83 | $314.28 | RVU15D |
| 2015-07-01 | $443.83 | $314.28 | RVU15C |
| 2015-04-01 | $441.62 | $312.72 | RVU15B |
| 2015-01-01 | $441.62 | $312.72 | RVU15A |
| 2014-10-01 | $439.40 | $312.68 | RVU14D |
| 2014-07-01 | $439.40 | $312.68 | RVU14C |
| 2014-04-01 | $439.40 | $312.68 | RVU14B |
| 2014-01-01 | $439.40 | $312.68 | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Metropolitan Boston, MA rate applies
Metropolitan Boston, MA is a Medicare payment area, not a city. Our Census mapping connects it to 60 cities and communities in Massachusetts. Some span more than one payment area; confirm with the service ZIP.
- Boston
- Arlington
- Ayer
- Bellingham
- Belmont
- Braintree Town
- Brookline
- Burlington
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
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