Billing code 11643: Malignant lesion excisionMedicare rate & RVUs in Alabama
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.
Medicare pays $285.94 for 11643 in the office in Alabama (Alabama). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
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.
11643 in Alabama
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $285.94 | $178.68 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 11643
Malignant lesion excision
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.
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
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%).
11643 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 11642Skin lesion excision
- Both codes cover the face, ears, eyelids, nose, or lips; choose 11642 when the lesion plus margins measures 1.1 to 2 cm.
- 11644Malignant lesion excision
- This is the next larger size level for the same anatomic group, used when the lesion plus margins measures 3.1 to 4 cm.
- 11623Skin excision
- The size range is the same, but 11623 applies to a different anatomic group: scalp, neck, hands, feet, or genitalia.
- 11603Lesion excision
- The size range is the same, but 11603 applies to malignant lesions on the trunk or extremities.
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
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