CPT code 11626: Skin excision, scalp, neck, hands, feet, genitalia; over 4 cm2026 Medicare rate & RVUs in Missouri
Excision of a malignant skin lesion on the scalp, neck, hands, feet, or genitalia, with margins producing an excised diameter greater than 4 cm.
Medicare pays $384.87–$407.53 for 11626 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 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.
Where 11626 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$384.87 to $407.53
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $403.72 | $248.79 |
| Metropolitan St. Louis, MO | $407.53 | $250.45 |
| Rest of Missouri | $384.87 | $242.64 |
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.
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%).
11626 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 11624Skin excision3.1–4 cm excised diameter
- Both codes cover the scalp, neck, hands, feet, and genitalia. Choose 11624 for an excised diameter of 3.1 to 4 cm; 11626 is for greater than 4 cm.
- 11606Lesion excisionTrunk or extremity, over 4 cm
- This code covers malignant lesions over 4 cm on the trunk, arms, or legs. Code 11626 is for the scalp, neck, hands, feet, or genitalia.
- 11646Malignant lesion excisionFace and related sites, over 4 cm
- This code covers malignant lesions over 4 cm on the face, ears, eyelids, nose, or lips. Code 11626 covers the scalp, neck, hands, feet, or genitalia.
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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