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

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 Tennessee, Medicare pays $385.24 for 11626 in the office and $235.25 when it’s performed in a hospital or facility.

$385.24Office (non-facility)
$235.25Hospital or facility
−8.1%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 Tennessee
  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 Tennessee 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. Tennessee pays $385.24. The RVUs are the same everywhere; the geographic indexes change the dollars.

11626 in Tennessee vs other payment areas
  1. Tennessee · this page$385.24
  2. Los Angeles, CA · California$461.42+$76.18
  3. Washington, DC area · District of Columbia$473.55+$88.31
  4. Miami, FL · Florida$467.99+$82.75
  5. Chicago, IL · Illinois$454.32+$69.08
  6. Manhattan, NY · New York$483.15+$97.91
  7. Alaska · Alaska$498.62+$113.38

Other areas in Tennessee 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 Tennessee 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

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Office calculation for 11626 in Tennessee
ComponentRVULocality factorAdjusted
Physician work4.49× 1.0004.4900
Practice expense7.30× 0.9096.6357
Malpractice0.76× 0.5370.4081
Total RVUs11.5338
Conversion factor× 33.4009

Office rate, Tennessee$385.24

Office: (4.49 × 1 + 7.3 × 0.909 + 0.76 × 0.537) × $33.4009 = $385.24

Facility: (4.49 × 1 + 2.36 × 0.909 + 0.76 × 0.537) × $33.4009 = $235.25

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, Tennessee
Same family
11624Skin excision, 3.1–4 cm excised diameterSame site group; applies when the excised diameter is 3.1 to 4 cm.$313.24
11621Skin lesion excision, scalp, neck, hands, feet, genitaliaSame site group; applies when the excised diameter is 0.6 to 1 cm.$210.86
Used instead
11606Lesion excision, trunk or extremity, over 4 cmFor a malignant lesion over 4 cm on the trunk, arms, or legs.$425.84
11646Malignant lesion excision, face and related sites, over 4 cmFor a malignant lesion over 4 cm on the face, ears, eyelids, nose, or lips.$475.21

How 11626 has changed in Tennessee

11626 · Office / nonfacility

$385.24

Effective 2026-10-01

The base rate is $24.62 higher than on 2025-10-01, moving from $360.62 to $385.24 (6.8%).

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

    $360.62changed to$385.24

    • 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
    • Practice expense GPCI 0.896 changed to 0.909
    • Malpractice GPCI 0.544 changed to 0.537

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $371.11changed to$360.62

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $365.05changed to$371.11

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $376.30changed to$365.05

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.75 changed to 0.77
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.518 changed to 0.544

  5. January 1, 2023

    RVU23A

    $380.22changed to$376.30

    • 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
    • Practice expense GPCI 0.892 changed to 0.894
    • Malpractice GPCI 0.492 changed to 0.518

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $381.78changed to$380.22

    • 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

    $384.24changed to$381.78

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.31 changed to 6.69
    • Practice expense GPCI 0.897 changed to 0.892
    • Malpractice GPCI 0.509 changed to 0.492

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $383.60changed to$384.24

    • 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
    • Practice expense GPCI 0.901 changed to 0.897
    • Malpractice GPCI 0.526 changed to 0.509

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $382.86changed to$383.60

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

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$382.86

    Held through RVU18C, RVU18D.

  11. 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, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$385.24$235.25RVU26D
2026-07-01$385.24$235.25RVU26C
2026-04-01$385.24$235.25RVU26B
2026-01-01$385.24$235.25RVU26A
2025-10-01$360.62$260.34RVU25D
2025-07-01$360.62$260.34RVU25C
2025-04-01$360.62$260.34RVU25B
2025-01-01$360.62$260.34RVU25A
2024-10-01$371.11$266.12RVU24D
2024-07-01$371.11$266.12RVU24C
2024-04-01$371.11$266.12RVU24B
2024-03-09$371.11$266.12RVU24AR
2024-01-01$365.05$261.78RVU24A
2023-10-01$376.30$269.36RVU23D
2023-07-01$376.30$269.36RVU23C
2023-04-01$376.30$269.36RVU23B
2023-01-01$376.30$269.36RVU23A
2022-10-01$380.22$271.87RVU22D
2022-07-01$380.22$271.87RVU22C
2022-04-01$380.22$271.87RVU22B
2022-01-01$380.22$271.87RVU22A
2021-10-01$381.78$272.23RVU21D
2021-07-01$381.78$272.23RVU21C
2021-04-01$381.78$272.23RVU21B
2021-01-01$381.78$272.23RVU21A
2020-10-01$384.24$280.00RVU20D
2020-07-01$384.24$280.00RVU20C
2020-04-01$384.24$280.00RVU20B
2020-01-01$384.24$280.00RVU20A
2019-10-01$383.60$280.99RVU19D
2019-07-01$383.60$280.99RVU19C
2019-04-01$383.60$280.99RVU19B
2019-01-01$383.60$280.99RVU19A
2018-10-01$382.86$280.36RVU18D
2018-07-01$382.86$280.36RVU18C
2018-04-01$382.86$280.36RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
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 Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

  • Adams
  • Adamsville
  • Alamo
  • Alcoa
  • Alexandria
  • Algood
  • Allardt
  • Altamont

Browse all communities in Tennessee

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 TennesseeGPCI2026.csv, line 95 (RVU26D)

Open CMS sourceHow we calculate rates

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