CPT code 11643: Malignant lesion excision, face, ears, eyelids, nose, lips2026 Medicare rate & RVUs in Idaho

Reports excision of a malignant skin lesion on the face, ear, eyelid, nose, or lip when the lesion plus margins measures 2.1 to 3 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality23K Medicare services in 2024

In Idaho, Medicare pays $293.17 for 11643 in the office and $180.40 when it’s performed in a hospital or facility.

$293.17Office (non-facility)
$180.40Hospital or facility
−7.2%vs the national office rate ($315.97)

Check a contract rate as a % of Medicare · 11643 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 11643 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Idaho
  2. What 11643 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 11643 covers

This service removes a malignant skin lesion from the face, ear, eyelid, nose, or lip, including the margins needed for excision. Dermatologists, plastic surgeons, and other physicians who perform skin cancer surgery may provide it in an office or facility. A basal cell or squamous cell carcinoma on the nose or ear is a typical clinical context. The code is selected by the greatest diameter of the lesion plus the margins taken, not by the final closure length. Document the site, malignant diagnosis, and measurement supporting the size range; report each separately excised lesion according to its own site and size.

Simple closure is included; a separately performed intermediate or complex repair may be reported when supported. Medicare includes related postoperative visits during the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 Idaho compares for 11643

Across 109 of 109 payment localities, the office rate for 11643 runs from $282.16 in Arkansas to $405.69 in San Benito County, CA. Idaho pays $293.17. The RVUs are the same everywhere; the geographic indexes change the dollars.

11643 in Idaho vs other payment areas
  1. Idaho · this page$293.17
  2. Los Angeles, CA · California$350.55+$57.38
  3. Washington, DC area · District of Columbia$357.49+$64.32
  4. Miami, FL · Florida$345.74+$52.57
  5. Chicago, IL · Illinois$336.30+$43.13
  6. Manhattan, NY · New York$362.35+$69.18
  7. Alaska · Alaska$377.51+$84.34

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

Every other payment area

11643 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$285.94$178.68
ArkansasArkansas$282.16$176.87
ArizonaArizona$308.00$189.22
Bakersfield, CACalifornia$330.75$196.40
Chico, CACalifornia$329.48$195.13
El Centro, CACalifornia$329.55$195.20
Fresno, CACalifornia$329.48$195.13
Hanford, CACalifornia$329.48$195.13

11643 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.

$282.16

$377.51

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

View every state and territory as a table
11643 office rate range by state
State / territoryOffice rate rangeLocalities
AK$377.511
AL$285.941
AR$282.161
AZ$308.001
CA$329.48–$405.6929
CO$326.351
CT$335.871
DC$357.491
DE$312.791
FL$314.82–$345.743
GA$298.17–$322.242
GU$336.011
HI$336.011
IA$291.131
ID$293.171
IL$307.50–$336.304
IN$294.691
KS$290.571
KY$293.621
LA$293.48–$306.692
MA$324.93–$355.892
MD$318.19–$357.493
ME$295.31–$308.962
MI$301.26–$319.162
MN$311.381
MO$289.33–$306.863
MS$285.761
MT$315.941
NC$298.031
ND$307.441
NE$292.381
NH$321.981
NJ$339.33–$354.422
NM$303.061
NV$313.761
NY$302.19–$371.385
OH$299.521
OK$292.401
OR$310.95–$335.212
PA$299.57–$328.552
PR$317.851
RI$322.821
SC$299.351
SD$306.441
TN$292.001
TX$297.82–$325.608
UT$303.081
VA$308.51–$357.492
VI$317.851
VT$306.971
WA$324.08–$362.122
WI$298.041
WV$297.221
WY$312.241

See 11643 in every payment locality

How the 11643 rate is calculated

Each of 11643’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 · 11643

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.33

3.33 RVUs× 1.000 GPCI

Practice expense5.70

5.70 RVUs× 1.000 GPCI

Malpractice0.43

0.43 RVUs× 1.000 GPCI

Adjusted RVUs

9.4600

Conversion factor

$33.4009

Medicare rate

$315.97

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

The exact Idaho inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,356

Code
11643
Physician work
3.33
Practice expense
5.70
Malpractice
0.43

GPCI2026.csv

47

Locality
Idaho
Physician work
1.000
Practice expense
0.920
Malpractice
0.473
Office calculation for 11643 in Idaho
ComponentRVULocality factorAdjusted
Physician work3.33× 1.0003.3300
Practice expense5.70× 0.9205.2440
Malpractice0.43× 0.4730.2034
Total RVUs8.7774
Conversion factor× 33.4009

Office rate, Idaho$293.17

Office: (3.33 × 1 + 5.7 × 0.92 + 0.43 × 0.473) × $33.4009 = $293.17

Facility: (3.33 × 1 + 2.03 × 0.92 + 0.43 × 0.473) × $33.4009 = $180.40

Open 11643 in the RVU calculator

Payment rules and modifiers for 11643

11643 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11643

Malignant 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 · 11643

Malignant 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

11643 without 51 · national office

$315.97

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

11643-51 · Second procedure: 50%

$157.99

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 11643 has changed in Idaho

11643 · Office / nonfacility

$293.17

Effective 2026-10-01

The base rate is $11.21 higher than on 2025-10-01, moving from $281.96 to $293.17 (4.0%).

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

    $281.96changed to$293.17

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.42 changed to 3.33
    • Practice expense RVU 5.59 changed to 5.70
    • Malpractice RVU 0.48 changed to 0.43
    • Practice expense GPCI 0.908 changed to 0.920
    • Malpractice GPCI 0.461 changed to 0.473

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $290.16changed to$281.96

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.60 changed to 5.59
    • Malpractice RVU 0.46 changed to 0.48

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $285.43changed to$290.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $291.30changed to$285.43

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.58 changed to 5.60
    • Malpractice RVU 0.44 changed to 0.46
    • Practice expense GPCI 0.893 changed to 0.908
    • Malpractice GPCI 0.439 changed to 0.461
  5. January 1, 2023

    RVU23A

    $291.47changed to$291.30

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.50 changed to 5.58
    • Malpractice RVU 0.43 changed to 0.44
    • Practice expense GPCI 0.877 changed to 0.893
    • Malpractice GPCI 0.416 changed to 0.439

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $293.42changed to$291.47

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.48 changed to 5.50
    • Malpractice RVU 0.44 changed to 0.43

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $297.82changed to$293.42

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.20 changed to 5.48
    • Practice expense GPCI 0.890 changed to 0.877
    • Malpractice GPCI 0.464 changed to 0.416

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $300.12changed to$297.82

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.14 changed to 5.20
    • Malpractice RVU 0.53 changed to 0.44
    • Practice expense GPCI 0.902 changed to 0.890
    • Malpractice GPCI 0.512 changed to 0.464

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $300.77changed to$300.12

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.17 changed to 5.14

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $298.64changed to$300.77

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.14 changed to 5.17
    • Malpractice RVU 0.54 changed to 0.53
    • Practice expense GPCI 0.900 changed to 0.902
    • Malpractice GPCI 0.510 changed to 0.512

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $296.89changed to$298.64

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.12 changed to 5.14
    • Practice expense GPCI 0.898 changed to 0.900
    • Malpractice GPCI 0.508 changed to 0.510

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $297.09changed to$296.89

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.11 changed to 5.12
    • Malpractice RVU 0.51 changed to 0.54

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $295.61changed to$297.09

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $294.64changed to$295.61

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.04 changed to 5.11
    • Malpractice RVU 0.52 changed to 0.51
    • Practice expense GPCI 0.896 changed to 0.898
    • Malpractice GPCI 0.556 changed to 0.508

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $298.68changed to$294.64

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.63 changed to 5.04
    • Malpractice RVU 0.54 changed to 0.52
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.603 changed to 0.556

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $298.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$293.17$180.40RVU26D
2026-07-01$293.17$180.40RVU26C
2026-04-01$293.17$180.40RVU26B
2026-01-01$293.17$180.40RVU26A
2025-10-01$281.96$204.72RVU25D
2025-07-01$281.96$204.72RVU25C
2025-04-01$281.96$204.72RVU25B
2025-01-01$281.96$204.72RVU25A
2024-10-01$290.16$208.86RVU24D
2024-07-01$290.16$208.86RVU24C
2024-04-01$290.16$208.86RVU24B
2024-03-09$290.16$208.86RVU24AR
2024-01-01$285.43$205.45RVU24A
2023-10-01$291.30$209.59RVU23D
2023-07-01$291.30$209.59RVU23C
2023-04-01$291.30$209.59RVU23B
2023-01-01$291.30$209.59RVU23A
2022-10-01$291.47$209.22RVU22D
2022-07-01$291.47$209.22RVU22C
2022-04-01$291.47$209.22RVU22B
2022-01-01$291.47$209.22RVU22A
2021-10-01$293.42$209.87RVU21D
2021-07-01$293.42$209.87RVU21C
2021-04-01$293.42$209.87RVU21B
2021-01-01$293.42$209.87RVU21A
2020-10-01$297.82$217.20RVU20D
2020-07-01$297.82$217.20RVU20C
2020-04-01$297.82$217.20RVU20B
2020-01-01$297.82$217.20RVU20A
2019-10-01$300.12$219.83RVU19D
2019-07-01$300.12$219.83RVU19C
2019-04-01$300.12$219.83RVU19B
2019-01-01$300.12$219.83RVU19A
2018-10-01$300.77$219.91RVU18D
2018-07-01$300.77$219.91RVU18C
2018-04-01$300.77$219.91RVU18B
2018-01-01$300.77$219.91RVU18AR1
2017-10-01$298.64$219.51RVU17D
2017-07-01$298.64$219.51RVU17C
2017-04-01$298.64$219.51RVU17B
2017-01-01$298.64$219.51RVU17A
2016-10-01$296.89$218.12RVU16D
2016-07-01$296.89$218.12RVU16C
2016-04-01$296.89$218.12RVU16B
2016-01-01$296.89$218.12RVU16A
2015-10-01$297.09$218.68RVU15D
2015-07-01$297.09$218.68RVU15C
2015-04-01$295.61$217.59RVU15B
2015-01-01$295.61$217.59RVU15A
2014-10-01$294.64$217.61RVU14D
2014-07-01$294.64$217.61RVU14C
2014-04-01$294.64$217.61RVU14B
2014-01-01$294.64$217.61RVU14A
2013-10-01$298.68$215.95RVU13D
2013-07-01$298.68$215.95RVU13C
2013-04-01$298.68$215.95RVU13B
2013-01-01$298.68$215.95RVU13AR

Price 11643 for an earlier date of service

Where the Idaho rate applies

Idaho is a Medicare payment area, not a city. Our Census mapping connects it to 235 cities and communities in Idaho. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Acequia
  • Albion
  • American Falls
  • Ammon
  • Arbon Valley
  • Arco
  • Arimo

Browse all communities in Idaho

11643 billing questions

How is the 2.1-to-3-cm size determined?

Use the greatest diameter of the lesion plus the margins required for excision. Do not use the length of the resulting wound or closure.

When should 11642 or 11644 be used instead?

Use 11642 for the same anatomic group when the lesion plus margins measures 1.1 to 2 cm. Use 11644 when it measures 3.1 to 4 cm.

Can the repair be billed separately?

Simple closure is included. An intermediate or complex repair may be separately reported when that repair is performed and documented.

Can modifier 50 be used for lesions on both sides?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Are assistant-at-surgery or co-surgeon claims payable?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

What postoperative care is included?

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

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 11643PPRRVU2026_Oct_nonQPP.csv, line 1,356 (RVU26D)
Geographic factors for IdahoGPCI2026.csv, line 47 (RVU26D)

Open CMS sourceHow we calculate rates

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