CPT code 11640: Lesion excision, face, 0.5 cm or less2026 Medicare rate & RVUs in South Dakota

Reports excision of a malignant skin lesion on the face or specified facial sites when the lesion and required margins measure 0.5 cm or less.

CMS RVU26DEffective Oct 1, 2026One payment locality3.8K Medicare services in 2024

In South Dakota, Medicare pays $197.97 for 11640 in the office and $106.46 when it’s performed in a hospital or facility.

$197.97Office (non-facility)
$106.46Hospital or facility
−2.2%vs the national office rate ($202.41)

Check a contract rate as a % of Medicare · 11640 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 11640 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 11640 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 11640 covers

This code covers removal of a malignant skin lesion from the face, ear, eyelid, nose, or lip, with the margins needed for excision. Dermatologists, plastic surgeons, and other qualified physicians commonly perform the procedure in an office or outpatient surgical setting. The size category is based on the excised diameter, including the lesion and margins—not the lesion alone. The code includes simple closure; a separately performed intermediate or complex repair may be reported when supported by the service and documentation.

Choose this code when the anatomic site is one of the specified facial sites and the excised diameter is 0.5 cm or less. Document the lesion’s location and size, the margins taken, and the resulting excised diameter; retain pathology findings supporting the malignant diagnosis. CMS assigns a 10-day global period, so related postoperative visits during that period are included. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery 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 South Dakota compares for 11640

Across 109 of 109 payment localities, the office rate for 11640 runs from $179.25 in Arkansas to $267.75 in San Benito County, CA. South Dakota pays $197.97. The RVUs are the same everywhere; the geographic indexes change the dollars.

11640 in South Dakota vs other payment areas
  1. South Dakota · this page$197.97
  2. Los Angeles, CA · California$228.25+$30.28
  3. Washington, DC area · District of Columbia$231.25+$33.28
  4. Miami, FL · Florida$218.42+$20.45
  5. Chicago, IL · Illinois$212.15+$14.18
  6. Manhattan, NY · New York$232.70+$34.73
  7. Alaska · Alaska$235.82+$37.85

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

Every other payment area

11640 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$181.85$101.77
ArkansasArkansas$179.25$100.63
ArizonaArizona$197.07$108.39
Bakersfield, CACalifornia$214.40$114.09
Chico, CACalifornia$213.80$113.49
El Centro, CACalifornia$213.83$113.53
Fresno, CACalifornia$213.80$113.49
Hanford, CACalifornia$213.80$113.49

11640 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.

$179.25

$240.78

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

View every state and territory as a table
11640 office rate range by state
State / territoryOffice rate rangeLocalities
AK$235.821
AL$181.851
AR$179.251
AZ$197.071
CA$213.80–$267.7529
CO$210.641
CT$215.781
DC$231.251
DE$200.311
FL$199.55–$218.423
GA$188.43–$206.182
GU$218.951
HI$218.951
IA$186.371
ID$187.591
IL$193.88–$212.154
IN$188.661
KS$185.531
KY$186.161
LA$185.88–$194.982
MA$209.41–$231.322
MD$204.10–$231.253
ME$188.58–$198.672
MI$190.98–$202.052
MN$201.801
MO$182.74–$195.643
MS$181.031
MT$202.401
NC$190.531
ND$198.441
NE$187.381
NH$207.371
NJ$218.23–$228.902
NM$192.031
NV$201.441
NY$193.36–$238.325
OH$190.171
OK$185.801
OR$199.86–$217.252
PA$190.46–$210.472
PR$203.861
RI$207.381
SC$190.671
SD$197.971
TN$186.461
TX$189.22–$209.958
UT$193.251
VA$198.04–$231.252
VI$203.861
VT$197.701
WA$209.01–$235.982
WI$191.851
WV$186.781
WY$200.671

See 11640 in every payment locality

How the 11640 rate is calculated

Each of 11640’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 · 11640

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.63

1.63 RVUs× 1.000 GPCI

Practice expense4.23

4.23 RVUs× 1.000 GPCI

Malpractice0.20

0.20 RVUs× 1.000 GPCI

Adjusted RVUs

6.0600

Conversion factor

$33.4009

Medicare rate

$202.41

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

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,353

Code
11640
Physician work
1.63
Practice expense
4.23
Malpractice
0.20

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 11640 in South Dakota
ComponentRVULocality factorAdjusted
Physician work1.63× 1.0001.6300
Practice expense4.23× 1.0004.2300
Malpractice0.20× 0.3360.0672
Total RVUs5.9272
Conversion factor× 33.4009

Office rate, South Dakota$197.97

Office: (1.63 × 1 + 4.23 × 1 + 0.2 × 0.336) × $33.4009 = $197.97

Facility: (1.63 × 1 + 1.49 × 1 + 0.2 × 0.336) × $33.4009 = $106.46

Open 11640 in the RVU calculator

Payment rules and modifiers for 11640

11640 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11640

Lesion excision, face, 0.5 cm or less

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 · 11640

Lesion excision, face, 0.5 cm or less

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

11640 without 51 · national office

$202.41

Lesion excision, face, 0.5 cm or less

11640-51 · Second procedure: 50%

$101.21

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

How 11640 has changed in South Dakota

11640 · Office / nonfacility

$197.97

Effective 2026-10-01

The base rate is $5.18 higher than on 2025-10-01, moving from $192.79 to $197.97 (2.7%).

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

    $192.79changed to$197.97

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.67 changed to 1.63
    • Practice expense RVU 4.21 changed to 4.23
    • Malpractice RVU 0.21 changed to 0.20
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $199.73changed to$192.79

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.25 changed to 4.21

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $196.47changed to$199.73

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $202.40changed to$196.47

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.23 changed to 4.25
    • Malpractice RVU 0.20 changed to 0.21
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $205.31changed to$202.40

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.19 changed to 4.23
    • Malpractice RVU 0.21 changed to 0.20
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $207.02changed to$205.31

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $203.45changed to$207.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.89 changed to 4.19
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $201.36changed to$203.45

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.82 changed to 3.89
    • Malpractice RVU 0.25 changed to 0.21
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $200.78changed to$201.36

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.81 changed to 3.82

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $198.78changed to$200.78

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.77 changed to 3.81
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $197.64changed to$198.78

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.75 changed to 3.77
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $197.85changed to$197.64

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.74 changed to 3.75
    • Malpractice RVU 0.24 changed to 0.25

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $196.87changed to$197.85

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $195.38changed to$196.87

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.68 changed to 3.74
    • Malpractice RVU 0.25 changed to 0.24
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $201.15changed to$195.38

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.13 changed to 3.68
    • Malpractice RVU 0.26 changed to 0.25
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $201.15

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$197.97$106.46RVU26D
2026-07-01$197.97$106.46RVU26C
2026-04-01$197.97$106.46RVU26B
2026-01-01$197.97$106.46RVU26A
2025-10-01$192.79$119.69RVU25D
2025-07-01$192.79$119.69RVU25C
2025-04-01$192.79$119.69RVU25B
2025-01-01$192.79$119.69RVU25A
2024-10-01$199.73$122.51RVU24D
2024-07-01$199.73$122.51RVU24C
2024-04-01$199.73$122.51RVU24B
2024-03-09$199.73$122.51RVU24AR
2024-01-01$196.47$120.51RVU24A
2023-10-01$202.40$123.11RVU23D
2023-07-01$202.40$123.11RVU23C
2023-04-01$202.40$123.11RVU23B
2023-01-01$202.40$123.11RVU23A
2022-10-01$205.31$123.30RVU22D
2022-07-01$205.31$123.30RVU22C
2022-04-01$205.31$123.30RVU22B
2022-01-01$205.31$123.30RVU22A
2021-10-01$207.02$123.27RVU21D
2021-07-01$207.02$123.27RVU21C
2021-04-01$207.02$123.27RVU21B
2021-01-01$207.02$123.27RVU21A
2020-10-01$203.45$124.77RVU20D
2020-07-01$203.45$124.77RVU20C
2020-04-01$203.45$124.77RVU20B
2020-01-01$203.45$124.77RVU20A
2019-10-01$201.36$124.60RVU19D
2019-07-01$201.36$124.60RVU19C
2019-04-01$201.36$124.60RVU19B
2019-01-01$201.36$124.60RVU19A
2018-10-01$200.78$124.10RVU18D
2018-07-01$200.78$124.10RVU18C
2018-04-01$200.78$124.10RVU18B
2018-01-01$200.78$124.10RVU18AR1
2017-10-01$198.78$123.41RVU17D
2017-07-01$198.78$123.41RVU17C
2017-04-01$198.78$123.41RVU17B
2017-01-01$198.78$123.41RVU17A
2016-10-01$197.64$122.81RVU16D
2016-07-01$197.64$122.81RVU16C
2016-04-01$197.64$122.81RVU16B
2016-01-01$197.64$122.81RVU16A
2015-10-01$197.85$123.47RVU15D
2015-07-01$197.85$123.47RVU15C
2015-04-01$196.87$122.85RVU15B
2015-01-01$196.87$122.85RVU15A
2014-10-01$195.38$122.30RVU14D
2014-07-01$195.38$122.30RVU14C
2014-04-01$195.38$122.30RVU14B
2014-01-01$195.38$122.30RVU14A
2013-10-01$201.15$122.56RVU13D
2013-07-01$201.15$122.56RVU13C
2013-04-01$201.15$122.56RVU13B
2013-01-01$201.15$122.56RVU13AR

Price 11640 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

11640 billing questions

How is the size category determined?

Use the excised diameter, including the lesion and the margins taken, rather than the lesion’s diameter alone. This code is for an excised diameter of 0.5 cm or less.

Which sites qualify for this code?

The site must be the face, ear, eyelid, nose, or lip. For the same size category on a different anatomic group, use the code assigned to that group.

Is simple closure separately reported?

Simple closure is included in the excision service. A separately performed intermediate or complex repair may be reported when its documentation supports that repair.

Are related postoperative visits separately payable during the global period?

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

What happens when multiple procedures are performed in the same session?

CMS pays the highest-valued procedure in full and applies the standard multiple procedure reduction to the other procedures.

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 11640PPRRVU2026_Oct_nonQPP.csv, line 1,353 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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