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CPT code 11642: Skin lesion excision, face, ears, eyelids, nose, lips2026 Medicare rate & RVUs in Kentucky

Report this code for excision of a malignant skin lesion on the face, ear, eyelid, nose, or lip when the excised diameter is 1.1–2 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality54.7K Medicare services in 2024

In Kentucky, Medicare pays $246.96 for 11642 in the office and $147.20 when it’s performed in a hospital or facility.

$246.96Office (non-facility)
$147.20Hospital or facility
−7.5%vs the national office rate ($266.87)

Check a contract rate as a % of Medicare · 11642 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 11642 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kentucky
  2. What 11642 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 11642 covers

This code covers conventional excision of a malignant skin lesion on the face, ears, eyelids, nose, or lips. Dermatologists, plastic surgeons, and other qualified clinicians commonly perform the procedure in an office or outpatient setting. The excision removes the lesion with the margins needed for the planned treatment; it is distinct from Mohs surgery. Simple closure is included, while a separately reportable intermediate or complex repair may be coded when its requirements are met.

Choose the code by the anatomic site group and the excised diameter: the lesion’s greatest diameter plus the narrowest margins removed. Document the diagnosis, exact site, lesion and margin measurements, and closure performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. CMS does not pay an assistant at surgery for this service and does not permit co-surgeon or team-surgery billing.

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 Kentucky compares for 11642

Across 109 of 109 payment localities, the office rate for 11642 runs from $237.81 in Arkansas to $347.48 in San Benito County, CA. Kentucky pays $246.96. The RVUs are the same everywhere; the geographic indexes change the dollars.

11642 in Kentucky vs other payment areas
  1. Kentucky · this page$246.96
  2. Los Angeles, CA · California$298.42+$51.46
  3. Washington, DC area · District of Columbia$303.16+$56.20
  4. Miami, FL · Florida$289.23+$42.27
  5. Chicago, IL · Illinois$281.30+$34.34
  6. Manhattan, NY · New York$306.01+$59.05
  7. Alaska · Alaska$316.12+$69.16

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

Every other payment area

11642 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$241.06$142.87
ArkansasArkansas$237.81$141.40
ArizonaArizona$260.11$151.36
Bakersfield, CACalifornia$281.05$158.05
Chico, CACalifornia$280.15$157.15
El Centro, CACalifornia$280.20$157.20
Fresno, CACalifornia$280.15$157.15
Hanford, CACalifornia$280.15$157.15

11642 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.

$237.81

$316.12

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

View every state and territory as a table
11642 office rate range by state
State / territoryOffice rate rangeLocalities
AK$316.121
AL$241.061
AR$237.811
AZ$260.111
CA$280.15–$347.4829
CO$276.691
CT$283.901
DC$303.161
DE$264.231
FL$264.36–$289.233
GA$250.26–$271.892
GU$286.171
HI$286.171
IA$246.241
ID$247.861
IL$257.58–$281.304
IN$249.191
KS$245.421
KY$246.961
LA$246.71–$258.112
MA$275.30–$302.572
MD$268.96–$303.163
ME$249.35–$261.632
MI$253.23–$267.742
MN$264.801
MO$242.92–$258.653
MS$240.391
MT$266.851
NC$251.751
ND$260.921
NE$247.421
NH$272.661
NJ$287.05–$300.392
NM$254.641
NV$265.371
NY$255.31–$313.365
OH$252.021
OK$246.271
OR$263.21–$284.732
PA$252.24–$277.382
PR$268.611
RI$273.071
SC$252.321
SD$260.221
TN$246.611
TX$250.71–$275.868
UT$255.551
VA$261.01–$303.162
VI$268.611
VT$260.211
WA$274.68–$308.272
WI$252.731
WV$248.701
WY$264.271

See 11642 in every payment locality

How the 11642 rate is calculated

Each of 11642’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 · 11642

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.55

2.55 RVUs× 1.000 GPCI

Practice expense5.14

5.14 RVUs× 1.000 GPCI

Malpractice0.30

0.30 RVUs× 1.000 GPCI

Adjusted RVUs

7.9900

Conversion factor

$33.4009

Medicare rate

$266.87

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

The exact Kentucky inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,355

Code
11642
Physician work
2.55
Practice expense
5.14
Malpractice
0.30

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Office calculation for 11642 in Kentucky
ComponentRVULocality factorAdjusted
Physician work2.55× 1.0002.5500
Practice expense5.14× 0.8894.5695
Malpractice0.30× 0.9150.2745
Total RVUs7.3940
Conversion factor× 33.4009

Office rate, Kentucky$246.96

Office: (2.55 × 1 + 5.14 × 0.889 + 0.3 × 0.915) × $33.4009 = $246.96

Facility: (2.55 × 1 + 1.78 × 0.889 + 0.3 × 0.915) × $33.4009 = $147.20

Open 11642 in the RVU calculator

Payment rules and modifiers for 11642

11642 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11642

Skin lesion excision, face, ears, eyelids, nose, lips

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 · 11642

Skin lesion excision, face, ears, eyelids, nose, lips

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

11642 without 51 · national office

$266.87

Skin lesion excision, face, ears, eyelids, nose, lips

11642-51 · Second procedure: 50%

$133.44

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 11642

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 11642
CodeHow it relatesOffice range, Kentucky
Same family
11641Malignant lesion excision, face, 0.6–1.0 cmSame site group, for an excised diameter of 0.6–1 cm.$218.91
11643Malignant lesion excision, face, ears, eyelids, nose, lipsSame site group, for an excised diameter of 2.1–3 cm.$293.62
Used instead
11602Malignant lesion excision, trunk or extremity, 1.1–2 cmSame size range, but for trunk, arms, or legs.$222.19
11622Skin lesion excision, designated sites, 1.1–2 cmSame size range, but for scalp, neck, hands, feet, or genitalia.$231.05
Often billed with
12051Facial repair, intermediate, 2.5 cm or lessMay describe a separately reportable intermediate repair at these sites when its criteria are met.$260.17

How 11642 has changed in Kentucky

11642 · Office / nonfacility

$246.96

Effective 2026-10-01

The base rate is $7.79 higher than on 2025-10-01, moving from $239.17 to $246.96 (3.3%).

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

    $239.17changed to$246.96

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.62 changed to 2.55
    • Practice expense RVU 5.10 changed to 5.14
    • Malpractice RVU 0.33 changed to 0.30
    • Practice expense GPCI 0.877 changed to 0.889
    • Malpractice GPCI 0.913 changed to 0.915

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $247.02changed to$239.17

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.12 changed to 5.10
    • Malpractice RVU 0.34 changed to 0.33

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $242.98changed to$247.02

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $248.80changed to$242.98

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.10 changed to 5.12
    • Malpractice RVU 0.31 changed to 0.34
    • Practice expense GPCI 0.873 changed to 0.877
    • Malpractice GPCI 0.870 changed to 0.913

  5. January 1, 2023

    RVU23A

    $250.79changed to$248.80

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.02 changed to 5.10
    • Malpractice RVU 0.32 changed to 0.31
    • Practice expense GPCI 0.869 changed to 0.873
    • Malpractice GPCI 0.827 changed to 0.870

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $252.58changed to$250.79

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.31 changed to 0.32

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $253.89changed to$252.58

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.75 changed to 5.02
    • Malpractice RVU 0.32 changed to 0.31
    • Practice expense GPCI 0.874 changed to 0.869
    • Malpractice GPCI 0.823 changed to 0.827

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $255.58changed to$253.89

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.70 changed to 4.75
    • Malpractice RVU 0.41 changed to 0.32
    • Practice expense GPCI 0.880 changed to 0.874
    • Malpractice GPCI 0.819 changed to 0.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $255.64changed to$255.58

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.72 changed to 4.70
    • Malpractice RVU 0.40 changed to 0.41

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $253.35changed to$255.64

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.69 changed to 4.72
    • Malpractice RVU 0.41 changed to 0.40
    • Practice expense GPCI 0.876 changed to 0.880
    • Malpractice GPCI 0.807 changed to 0.819

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $251.28changed to$253.35

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.67 changed to 4.69
    • Practice expense GPCI 0.872 changed to 0.876
    • Malpractice GPCI 0.795 changed to 0.807

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $250.73changed to$251.28

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.66 changed to 4.67
    • Malpractice RVU 0.37 changed to 0.41

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $249.48changed to$250.73

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $246.87changed to$249.48

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.57 changed to 4.66
    • Malpractice GPCI 0.774 changed to 0.795

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $251.44changed to$246.87

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.14 changed to 4.57
    • Malpractice RVU 0.39 changed to 0.37
    • Practice expense GPCI 0.871 changed to 0.872
    • Malpractice GPCI 0.752 changed to 0.774

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $251.44

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$246.96$147.20RVU26D
2026-07-01$246.96$147.20RVU26C
2026-04-01$246.96$147.20RVU26B
2026-01-01$246.96$147.20RVU26A
2025-10-01$239.17$166.26RVU25D
2025-07-01$239.17$166.26RVU25C
2025-04-01$239.17$166.26RVU25B
2025-01-01$239.17$166.26RVU25A
2024-10-01$247.02$170.24RVU24D
2024-07-01$247.02$170.24RVU24C
2024-04-01$247.02$170.24RVU24B
2024-03-09$247.02$170.24RVU24AR
2024-01-01$242.98$167.46RVU24A
2023-10-01$248.80$170.70RVU23D
2023-07-01$248.80$170.70RVU23C
2023-04-01$248.80$170.70RVU23B
2023-01-01$248.80$170.70RVU23A
2022-10-01$250.79$171.10RVU22D
2022-07-01$250.79$171.10RVU22C
2022-04-01$250.79$171.10RVU22B
2022-01-01$250.79$171.10RVU22A
2021-10-01$252.58$171.32RVU21D
2021-07-01$252.58$171.32RVU21C
2021-04-01$252.58$171.32RVU21B
2021-01-01$252.58$171.32RVU21A
2020-10-01$253.89$175.98RVU20D
2020-07-01$253.89$175.98RVU20C
2020-04-01$253.89$175.98RVU20B
2020-01-01$253.89$175.98RVU20A
2019-10-01$255.58$178.52RVU19D
2019-07-01$255.58$178.52RVU19C
2019-04-01$255.58$178.52RVU19B
2019-01-01$255.58$178.52RVU19A
2018-10-01$255.64$178.03RVU18D
2018-07-01$255.64$178.03RVU18C
2018-04-01$255.64$178.03RVU18B
2018-01-01$255.64$178.03RVU18AR1
2017-10-01$253.35$177.58RVU17D
2017-07-01$253.35$177.58RVU17C
2017-04-01$253.35$177.58RVU17B
2017-01-01$253.35$177.58RVU17A
2016-10-01$251.28$176.35RVU16D
2016-07-01$251.28$176.35RVU16C
2016-04-01$251.28$176.35RVU16B
2016-01-01$251.28$176.35RVU16A
2015-10-01$250.73$176.16RVU15D
2015-07-01$250.73$176.16RVU15C
2015-04-01$249.48$175.28RVU15B
2015-01-01$249.48$175.28RVU15A
2014-10-01$246.87$173.77RVU14D
2014-07-01$246.87$173.77RVU14C
2014-04-01$246.87$173.77RVU14B
2014-01-01$246.87$173.77RVU14A
2013-10-01$251.44$172.31RVU13D
2013-07-01$251.44$172.31RVU13C
2013-04-01$251.44$172.31RVU13B
2013-01-01$251.44$172.31RVU13AR

Price 11642 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

  • Adairville
  • Ages
  • Albany
  • Alexandria
  • Allen
  • Allensville
  • Anchorage
  • Annville

Browse all communities in Kentucky

11642 billing questions

How is the 1.1–2 cm size determined?

Use the excised diameter: the lesion’s greatest diameter plus the narrowest margins removed. Document the measurements that support the selected size range.

Does the code include closing the wound?

Simple closure is included. An intermediate or complex repair may be separately reported when supported by the repair documentation and applicable coding requirements.

When should 11641 be used instead?

Use 11641 for the same anatomic site group when the excised diameter is 0.6–1 cm. The size is based on the lesion and margins, not the length of the closure.

Does the 10-day global period include wound checks?

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

What happens if another procedure is performed in the same session?

The highest-valued procedure is paid in full, and the other procedures are subject to the standard multiple-procedure reduction.

Can an assistant surgeon or co-surgeon be billed?

CMS does not pay an assistant at surgery for this service and does not permit co-surgeon or team-surgery billing.

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 11642PPRRVU2026_Oct_nonQPP.csv, line 1,355 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)

Open CMS sourceHow we calculate rates

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