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

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 Puerto Rico, Medicare pays $317.85 for 11643 in the office and $193.92 when it’s performed in a hospital or facility.

$317.85Office (non-facility)
$193.92Hospital or facility
+0.6%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 Puerto Rico
  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 Puerto Rico 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. Puerto Rico pays $317.85. The RVUs are the same everywhere; the geographic indexes change the dollars.

11643 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$317.85
  2. Los Angeles, CA · California$350.55+$32.70
  3. Washington, DC area · District of Columbia$357.49+$39.64
  4. Miami, FL · Florida$345.74+$27.89
  5. Chicago, IL · Illinois$336.30+$18.45
  6. Manhattan, NY · New York$362.35+$44.50
  7. Alaska · Alaska$377.51+$59.66

Other areas in Puerto Rico 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.

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.

$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 Puerto Rico 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

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 11643 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work3.33× 1.0003.3300
Practice expense5.70× 1.0115.7627
Malpractice0.43× 0.9850.4235
Total RVUs9.5163
Conversion factor× 33.4009

Office rate, Puerto Rico$317.85

Office: (3.33 × 1 + 5.7 × 1.011 + 0.43 × 0.985) × $33.4009 = $317.85

Facility: (3.33 × 1 + 2.03 × 1.011 + 0.43 × 0.985) × $33.4009 = $193.92

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

Codes related to 11643

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

Codes related to 11643
CodeHow it relatesOffice range, Puerto Rico
Same family
11642Skin lesion excision, face, ears, eyelids, nose, lipsSame anatomic group, for lesion-plus-margin diameters of 1.1 to 2 cm.$268.61
11644Malignant lesion excision, face and related sites, 3.1-4 cmSame anatomic group, for lesion-plus-margin diameters of 3.1 to 4 cm.$395.05
11623Skin excision, scalp, neck, hand, foot, genital skinMalignant-lesion excision in a different anatomic group, with a 2.1-to-3-cm size range.$297.07
11603Lesion excision, trunk or limb, 2.1–3 cmMalignant-lesion excision for the trunk or extremities, with a 2.1-to-3-cm size range.$277.97

How 11643 has changed in Puerto Rico

11643 · Office / nonfacility

$317.85

Effective 2026-10-01

The base rate is $9.90 higher than on 2025-10-01, moving from $307.95 to $317.85 (3.2%).

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

    $307.95changed to$317.85

    • 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 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $316.59changed to$307.95

    • 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

    $311.43changed to$316.59

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $321.17changed to$311.43

    • 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 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $319.90changed to$321.17

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $324.88changed to$319.90

    • 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 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $327.22changed to$324.88

    • 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.

  8. January 1, 2021

    RVU21A

    $328.28changed to$327.22

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.20 changed to 5.48
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $328.70changed to$328.28

    • 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 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $329.43changed to$328.70

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

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $293.09changed to$329.43

    • 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 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $257.35changed to$293.09

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.12 changed to 5.14
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $257.71changed to$257.35

    • 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.

  14. July 1, 2015

    RVU15C

    $256.43changed to$257.71

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $252.50changed to$256.43

    • 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 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $250.80changed to$252.50

    • 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 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $250.80

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$317.85$193.92RVU26D
2026-07-01$317.85$193.92RVU26C
2026-04-01$317.85$193.92RVU26B
2026-01-01$317.85$193.92RVU26A
2025-10-01$307.95$222.29RVU25D
2025-07-01$307.95$222.29RVU25C
2025-04-01$307.95$222.29RVU25B
2025-01-01$307.95$222.29RVU25A
2024-10-01$316.59$226.42RVU24D
2024-07-01$316.59$226.42RVU24C
2024-04-01$316.59$226.42RVU24B
2024-03-09$316.59$226.42RVU24AR
2024-01-01$311.43$222.73RVU24A
2023-10-01$321.17$228.94RVU23D
2023-07-01$319.90$228.40RVU23C
2023-04-01$319.90$228.40RVU23B
2023-01-01$319.90$228.40RVU23A
2022-10-01$324.88$230.35RVU22D
2022-07-01$324.88$230.35RVU22C
2022-04-01$324.88$230.35RVU22B
2022-01-01$324.88$230.35RVU22A
2021-10-01$327.22$231.20RVU21D
2021-07-01$327.22$231.20RVU21C
2021-04-01$327.22$231.20RVU21B
2021-01-01$327.22$231.20RVU21A
2020-10-01$328.28$236.97RVU20D
2020-07-01$328.28$236.97RVU20C
2020-04-01$328.28$236.97RVU20B
2020-01-01$328.28$236.97RVU20A
2019-10-01$328.70$239.06RVU19D
2019-07-01$328.70$239.06RVU19C
2019-04-01$328.70$239.06RVU19B
2019-01-01$328.70$239.06RVU19A
2018-10-01$329.43$239.16RVU18D
2018-07-01$329.43$239.16RVU18C
2018-04-01$329.43$239.16RVU18B
2018-01-01$329.43$239.16RVU18AR1
2017-10-01$293.09$217.82RVU17D
2017-07-01$293.09$217.82RVU17C
2017-04-01$293.09$217.82RVU17B
2017-01-01$293.09$217.82RVU17A
2016-10-01$257.35$195.51RVU16D
2016-07-01$257.35$195.51RVU16C
2016-04-01$257.35$195.51RVU16B
2016-01-01$257.35$195.51RVU16A
2015-10-01$257.71$196.15RVU15D
2015-07-01$257.71$196.15RVU15C
2015-04-01$256.43$195.18RVU15B
2015-01-01$256.43$195.18RVU15A
2014-10-01$252.50$193.01RVU14D
2014-07-01$252.50$193.01RVU14C
2014-04-01$252.50$193.01RVU14B
2014-01-01$252.50$193.01RVU14A
2013-10-01$250.80$188.06RVU13D
2013-07-01$250.80$188.06RVU13C
2013-04-01$250.80$188.06RVU13B
2013-01-01$250.80$188.06RVU13AR

Price 11643 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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 Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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