$286.17
Both codes cover the face, ears, eyelids, nose, or lips; choose 11642 when the lesion plus margins measures 1.1 to 2 cm.
On this page
CMS RVU26D · Effective 2026-10-01
11643 Malignant lesion excision Medicare reimbursement rates in Guam
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. Compare 11643 office and facility rates across CMS payment localities in Guam.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 11643 in Guam?
Guam has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$336.01
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$196.63
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Dermatology procedure
About 11643: Malignant facial lesion excision, 2.1 to 3 cm
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.
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.
CMS billing rules for 11643
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.33 · 35%
- Practice expense (office) RVU5.70 · 60%
- Malpractice RVU0.43 · 5%
23K
Medicare services in 2024 · #1087 by national volume
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 compared with similar codes
Office rates for Guam, from the same CMS release.
$416.26
This is the next larger size level for the same anatomic group, used when the lesion plus margins measures 3.1 to 4 cm.
$314.77
The size range is the same, but 11623 applies to a different anatomic group: scalp, neck, hands, feet, or genitalia.
$295.33
The size range is the same, but 11603 applies to malignant lesions on the trunk or extremities.
Compare 11643 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$336.01
Facility
$196.63
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 11643 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
1,356
- Code
- 11643
- Physician work
- 3.33
- Practice expense
- 5.70
- Malpractice
- 0.43
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.33 | × 1.000 | 3.3300 |
| Practice expense | 5.70 | × 1.137 | 6.4809 |
| Malpractice | 0.43 | × 0.579 | 0.2490 |
| Total RVUs | 10.0599 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$336.01
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.33 | 1 |
| Practice expense | 5.7 | 1.137 |
| Malpractice | 0.43 | 0.579 |
(3.33 × 1 + 5.7 × 1.137 + 0.43 × 0.579) × $33.4009 = $336.01
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.33 | 1 |
| Practice expense | 2.03 | 1.137 |
| Malpractice | 0.43 | 0.579 |
(3.33 × 1 + 2.03 × 1.137 + 0.43 × 0.579) × $33.4009 = $196.63
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,35311640,,Exc f/e/e/n/l mal+mrg 0.5cm<,A,,1.63,4.23,,1.49,,0.20,6.06,3.32,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,35411641,,Exc f/e/e/n/l mal+mrg 0.6-1,A,,2.12,4.72,,1.65,,0.26,7.10,4.03,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,35511642,,Exc f/e/e/n/l mal+mrg 1.1-2,A,,2.55,5.14,,1.78,,0.30,7.99,4.63,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,35611643,,Exc f/e/e/n/l mal+mrg 2.1-3,A,,3.33,5.70,,2.03,,0.43,9.46,5.79,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,35711644,,Exc f/e/e/n/l mal+mrg 3.1-4,A,,4.23,6.94,,2.36,,0.59,11.76,7.18,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,35811646,,Exc f/e/e/n/l mal+mrg >4 cm,A,,6.10,8.38,,2.92,,0.95,15.43,9.97,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,3591170F,,Fxnl status assessed,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014