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CPT code 11626: Skin excision, scalp, neck, hands, feet, genitalia; over 4 cm2026 Medicare rate & RVUs in Rhode Island

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 Rhode Island, Medicare pays $427.34 for 11626 in the office and $256.89 when it’s performed in a hospital or facility.

$427.34Office (non-facility)
$256.89Hospital or facility
+1.9%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 Rhode Island
  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 Rhode Island 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. Rhode Island pays $427.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

11626 in Rhode Island vs other payment areas
  1. Rhode Island · this page$427.34
  2. Los Angeles, CA · California$461.42+$34.08
  3. Washington, DC area · District of Columbia$473.55+$46.21
  4. Miami, FL · Florida$467.99+$40.65
  5. Chicago, IL · Illinois$454.32+$26.98
  6. Manhattan, NY · New York$483.15+$55.81
  7. Alaska · Alaska$498.62+$71.28

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

Every other payment area

11626 in every other Medicare payment locality
Payment localityOfficeFacility
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

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 Rhode Island 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

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Office calculation for 11626 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work4.49× 1.0194.5753
Practice expense7.30× 1.0337.5409
Malpractice0.76× 0.8920.6779
Total RVUs12.7941
Conversion factor× 33.4009

Office rate, Rhode Island$427.34

Office: (4.49 × 1.019 + 7.3 × 1.033 + 0.76 × 0.892) × $33.4009 = $427.34

Facility: (4.49 × 1.019 + 2.36 × 1.033 + 0.76 × 0.892) × $33.4009 = $256.89

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, Rhode Island
Same family
11624Skin excision, 3.1–4 cm excised diameterSame site group; applies when the excised diameter is 3.1 to 4 cm.$346.64
11621Skin lesion excision, scalp, neck, hands, feet, genitaliaSame site group; applies when the excised diameter is 0.6 to 1 cm.$233.92
Used instead
11606Lesion excision, trunk or extremity, over 4 cmFor a malignant lesion over 4 cm on the trunk, arms, or legs.$472.66
11646Malignant lesion excision, face and related sites, over 4 cmFor a malignant lesion over 4 cm on the face, ears, eyelids, nose, or lips.$525.06

How 11626 has changed in Rhode Island

11626 · Office / nonfacility

$427.34

Effective 2026-10-01

The base rate is $23.81 higher than on 2025-10-01, moving from $403.53 to $427.34 (5.9%).

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

    $403.53changed to$427.34

    • 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 1.025 changed to 1.019
    • Practice expense GPCI 1.039 changed to 1.033
    • Malpractice GPCI 0.849 changed to 0.892

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $415.27changed to$403.53

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $408.50changed to$415.27

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $424.70changed to$408.50

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.75 changed to 0.77
    • Work GPCI 1.023 changed to 1.025
    • Practice expense GPCI 1.044 changed to 1.039
    • Malpractice GPCI 0.915 changed to 0.849

  5. January 1, 2023

    RVU23A

    $432.76changed to$424.70

    • 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 1.021 changed to 1.023
    • Practice expense GPCI 1.048 changed to 1.044
    • Malpractice GPCI 0.981 changed to 0.915

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $434.21changed to$432.76

    • 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.

  7. January 1, 2021

    RVU21A

    $435.69changed to$434.21

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.31 changed to 6.69
    • Work GPCI 1.024 changed to 1.021
    • Practice expense GPCI 1.049 changed to 1.048
    • Malpractice GPCI 0.990 changed to 0.981

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $435.18changed to$435.69

    • 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 1.027 changed to 1.024
    • Practice expense GPCI 1.050 changed to 1.049
    • Malpractice GPCI 0.999 changed to 0.990

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $434.32changed to$435.18

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.22 changed to 6.23

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $428.84changed to$434.32

    • 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 1.027
    • Practice expense GPCI 1.052 changed to 1.050
    • Malpractice GPCI 0.879 changed to 0.999

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $423.59changed to$428.84

    • 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 1.022 changed to 1.025
    • Practice expense GPCI 1.053 changed to 1.052
    • Malpractice GPCI 0.759 changed to 0.879

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $424.30changed to$423.59

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.79 changed to 0.82

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $422.19changed to$424.30

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $425.01changed to$422.19

    • 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 1.020 changed to 1.022
    • Malpractice GPCI 0.973 changed to 0.759

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$425.01

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$427.34$256.89RVU26D
2026-07-01$427.34$256.89RVU26C
2026-04-01$427.34$256.89RVU26B
2026-01-01$427.34$256.89RVU26A
2025-10-01$403.53$287.25RVU25D
2025-07-01$403.53$287.25RVU25C
2025-04-01$403.53$287.25RVU25B
2025-01-01$403.53$287.25RVU25A
2024-10-01$415.27$293.53RVU24D
2024-07-01$415.27$293.53RVU24C
2024-04-01$415.27$293.53RVU24B
2024-03-09$415.27$293.53RVU24AR
2024-01-01$408.50$288.74RVU24A
2023-10-01$424.70$299.82RVU23D
2023-07-01$424.70$299.82RVU23C
2023-04-01$424.70$299.82RVU23B
2023-01-01$424.70$299.82RVU23A
2022-10-01$432.76$305.47RVU22D
2022-07-01$432.76$305.47RVU22C
2022-04-01$432.76$305.47RVU22B
2022-01-01$432.76$305.47RVU22A
2021-10-01$434.21$305.49RVU21D
2021-07-01$434.21$305.49RVU21C
2021-04-01$434.21$305.49RVU21B
2021-01-01$434.21$305.49RVU21A
2020-10-01$435.69$313.79RVU20D
2020-07-01$435.69$313.79RVU20C
2020-04-01$435.69$313.79RVU20B
2020-01-01$435.69$313.79RVU20A
2019-10-01$435.18$315.60RVU19D
2019-07-01$435.18$315.60RVU19C
2019-04-01$435.18$315.60RVU19B
2019-01-01$435.18$315.60RVU19A
2018-10-01$434.32$314.88RVU18D
2018-07-01$434.32$314.88RVU18C
2018-04-01$434.32$314.88RVU18B
2018-01-01$434.32$314.88RVU18AR1
2017-10-01$428.84$311.42RVU17D
2017-07-01$428.84$311.42RVU17C
2017-04-01$428.84$311.42RVU17B
2017-01-01$428.84$311.42RVU17A
2016-10-01$423.59$306.34RVU16D
2016-07-01$423.59$306.34RVU16C
2016-04-01$423.59$306.34RVU16B
2016-01-01$423.59$306.34RVU16A
2015-10-01$424.30$307.01RVU15D
2015-07-01$424.30$307.01RVU15C
2015-04-01$422.19$305.48RVU15B
2015-01-01$422.19$305.48RVU15A
2014-10-01$425.01$309.58RVU14D
2014-07-01$425.01$309.58RVU14C
2014-04-01$425.01$309.58RVU14B
2014-01-01$425.01$309.58RVU14A
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 Rhode Island rate applies

Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.

  • Ashaway
  • Bradford
  • Carolina
  • Central Falls
  • Charlestown
  • Chepachet
  • Clayville
  • Cranston

Browse all communities in Rhode Island

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 Rhode IslandGPCI2026.csv, line 92 (RVU26D)

Open CMS sourceHow we calculate rates

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