Billing code 11443: Skin excisionMedicare rate & RVUs

Medicare pays $230.13 for 11443 nationally in the office and $159.32 in a hospital or facility. Local office rates run $204.97–$297.49.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 11443 covers

This service removes a lesion believed to be benign from the face, ears, eyelids, nose, or lips, including a margin of surrounding skin. Dermatologists, plastic surgeons, and other qualified clinicians commonly perform it in an office procedure room or an outpatient facility. A specimen may be submitted for histopathology, which can confirm the diagnosis; the excision code is selected based on the lesion’s clinical classification and the excised diameter, not the eventual pathology result alone.

Measure the greatest diameter of the lesion plus the narrowest margins needed for removal, and document the site, lesion size, and margins so the reported size falls within 2.1 to 3 cm. Simple closure is included; a separately reportable intermediate or complex repair may be coded based on its own criteria. The procedure has a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is 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.

Where 11443 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

11443 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 11443 rate is calculated

Each of 11443’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.

Payment rules and modifiers for 11443

11443 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

11443 compared with similar codes

How to choose

11442Facial lesion excision

Use 11442 for a benign lesion at the same facial sites when the excised diameter is 1.1 to 2 cm; use 11443 when it is 2.1 to 3 cm.

11444Skin excision

Use 11444 for the same type of benign facial lesion excision when the excised diameter is 3.1 to 4 cm.

11423Skin excision

The size range and benign-lesion excision method are similar, but 11423 is for scalp, neck, hands, feet, or genitalia rather than the face and related sites.

11643Malignant lesion excision

Use 11643 for excision of a lesion treated as malignant at these facial sites and in this size range; 11443 is for lesions treated as benign.

Codes related to 11443

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

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

Open CMS sourceHow we calculate rates