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

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 West Virginia, Medicare pays $186.78 for 11640 in the office and $107.25 when it’s performed in a hospital or facility.

$186.78Office (non-facility)
$107.25Hospital or facility
−7.7%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 West Virginia
  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 West Virginia 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. West Virginia pays $186.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

11640 in West Virginia vs other payment areas
  1. West Virginia · this page$186.78
  2. Los Angeles, CA · California$228.25+$41.47
  3. Washington, DC area · District of Columbia$231.25+$44.47
  4. Miami, FL · Florida$218.42+$31.64
  5. Chicago, IL · Illinois$212.15+$25.37
  6. Manhattan, NY · New York$232.70+$45.92
  7. Alaska · Alaska$235.82+$49.04

Other areas in West Virginia 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 West Virginia 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

110

Locality
West Virginia
Physician work
1.000
Practice expense
0.869
Malpractice
1.431
Office calculation for 11640 in West Virginia
ComponentRVULocality factorAdjusted
Physician work1.63× 1.0001.6300
Practice expense4.23× 0.8693.6759
Malpractice0.20× 1.4310.2862
Total RVUs5.5921
Conversion factor× 33.4009

Office rate, West Virginia$186.78

Office: (1.63 × 1 + 4.23 × 0.869 + 0.2 × 1.431) × $33.4009 = $186.78

Facility: (1.63 × 1 + 1.49 × 0.869 + 0.2 × 1.431) × $33.4009 = $107.25

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 West Virginia

11640 · Office / nonfacility

$186.78

Effective 2026-10-01

The base rate is $6.32 higher than on 2025-10-01, moving from $180.46 to $186.78 (3.5%).

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

    $180.46changed to$186.78

    • 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
    • Practice expense GPCI 0.862 changed to 0.869
    • Malpractice GPCI 1.333 changed to 1.431

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $186.86changed to$180.46

    • 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

    $183.81changed to$186.86

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $188.45changed to$183.81

    • 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
    • Practice expense GPCI 0.860 changed to 0.862
    • Malpractice GPCI 1.266 changed to 1.333
  5. January 1, 2023

    RVU23A

    $190.91changed to$188.45

    • 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
    • Practice expense GPCI 0.858 changed to 0.860
    • Malpractice GPCI 1.198 changed to 1.266

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $192.49changed to$190.91

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $190.03changed to$192.49

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.89 changed to 4.19
    • Practice expense GPCI 0.857 changed to 0.858
    • Malpractice GPCI 1.247 changed to 1.198

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $189.84changed to$190.03

    • 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 1.296 changed to 1.247

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $189.33changed to$189.84

    • 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

    $186.10changed to$189.33

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.77 changed to 3.81
    • Practice expense GPCI 0.847 changed to 0.857
    • Malpractice GPCI 1.289 changed to 1.296

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $183.51changed to$186.10

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.75 changed to 3.77
    • Practice expense GPCI 0.836 changed to 0.847
    • Malpractice GPCI 1.282 changed to 1.289

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $183.42changed to$183.51

    • 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

    $182.50changed to$183.42

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $180.75changed to$182.50

    • 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
    • Practice expense GPCI 0.832 changed to 0.836
    • Malpractice GPCI 1.256 changed to 1.282

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $184.04changed to$180.75

    • 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
    • Practice expense GPCI 0.828 changed to 0.832
    • Malpractice GPCI 1.229 changed to 1.256

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $184.04

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$186.78$107.25RVU26D
2026-07-01$186.78$107.25RVU26C
2026-04-01$186.78$107.25RVU26B
2026-01-01$186.78$107.25RVU26A
2025-10-01$180.46$117.44RVU25D
2025-07-01$180.46$117.44RVU25C
2025-04-01$180.46$117.44RVU25B
2025-01-01$180.46$117.44RVU25A
2024-10-01$186.86$120.29RVU24D
2024-07-01$186.86$120.29RVU24C
2024-04-01$186.86$120.29RVU24B
2024-03-09$186.86$120.29RVU24AR
2024-01-01$183.81$118.32RVU24A
2023-10-01$188.45$120.25RVU23D
2023-07-01$188.45$120.25RVU23C
2023-04-01$188.45$120.25RVU23B
2023-01-01$188.45$120.25RVU23A
2022-10-01$190.91$120.54RVU22D
2022-07-01$190.91$120.54RVU22C
2022-04-01$190.91$120.54RVU22B
2022-01-01$190.91$120.54RVU22A
2021-10-01$192.49$120.64RVU21D
2021-07-01$192.49$120.64RVU21C
2021-04-01$192.49$120.64RVU21B
2021-01-01$192.49$120.64RVU21A
2020-10-01$190.03$122.61RVU20D
2020-07-01$190.03$122.61RVU20C
2020-04-01$190.03$122.61RVU20B
2020-01-01$190.03$122.61RVU20A
2019-10-01$189.84$124.06RVU19D
2019-07-01$189.84$124.06RVU19C
2019-04-01$189.84$124.06RVU19B
2019-01-01$189.84$124.06RVU19A
2018-10-01$189.33$123.61RVU18D
2018-07-01$189.33$123.61RVU18C
2018-04-01$189.33$123.61RVU18B
2018-01-01$189.33$123.61RVU18AR1
2017-10-01$186.10$122.26RVU17D
2017-07-01$186.10$122.26RVU17C
2017-04-01$186.10$122.26RVU17B
2017-01-01$186.10$122.26RVU17A
2016-10-01$183.51$120.96RVU16D
2016-07-01$183.51$120.96RVU16C
2016-04-01$183.51$120.96RVU16B
2016-01-01$183.51$120.96RVU16A
2015-10-01$183.42$121.23RVU15D
2015-07-01$183.42$121.23RVU15C
2015-04-01$182.50$120.63RVU15B
2015-01-01$182.50$120.63RVU15A
2014-10-01$180.75$119.95RVU14D
2014-07-01$180.75$119.95RVU14C
2014-04-01$180.75$119.95RVU14B
2014-01-01$180.75$119.95RVU14A
2013-10-01$184.04$118.96RVU13D
2013-07-01$184.04$118.96RVU13C
2013-04-01$184.04$118.96RVU13B
2013-01-01$184.04$118.96RVU13AR

Price 11640 for an earlier date of service

Where the West Virginia rate applies

West Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 439 cities and communities in West Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Accoville
  • Addison (Webster Springs)
  • Adrian
  • Albright
  • Alderson
  • Alum Creek
  • Amherstdale
  • Anawalt

Browse all communities in West Virginia

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 West VirginiaGPCI2026.csv, line 110 (RVU26D)

Open CMS sourceHow we calculate rates

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