Billing code 11600: Malignant lesion excisionMedicare rate & RVUs

Medicare pays $198.40 for 11600 nationally in the office and $108.55 in a hospital or facility. Local office rates run $175.50–$262.11.

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

What 11600 covers

This code describes removal of a malignant skin lesion from the trunk, an arm, or a leg, with margins included in the measured excision. Dermatologists, surgeons, and other qualified clinicians may perform it in an office procedure room or a facility. The size category is based on the lesion’s greatest clinical diameter plus the margins taken, not just the visible lesion. Typical cases include excision of a small malignant lesion on the back, torso, or extremity.

Report the code when the excised diameter is 0.5 cm or less and the site falls within this anatomic group. Documentation should identify the site, lesion dimensions, margins or excised diameter, and clinical or pathology support for malignancy. Simple closure is included; a separately documented intermediate or complex repair may be reported under its repair code. The procedure has a 10-day global period, including related postoperative visits during that period. When multiple procedures occur in one session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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 11600 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

11600 rates by state

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

How the 11600 rate is calculated

Each of 11600’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 11600

11600 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

11600 compared with similar codes

How to choose

11601Malignant skin excision

Both codes cover malignant lesions on the trunk, arms, or legs. Choose 11601 when the lesion plus margins measures 0.6–1 cm rather than 0.5 cm or less.

11620Skin excision

The size category is similar, but 11620 applies to the scalp, neck, hands, feet, or genitalia rather than the trunk, arms, or legs.

11640Lesion excision

This code is for the face, ears, eyelids, nose, and lips. Use 11600 for the trunk, arms, or legs.

11400Skin lesion excision

11400 is for excision of a benign lesion on the trunk, arms, or legs in the same small size range; 11600 is for a malignant lesion.

Codes related to 11600

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