Billing code 11621: Skin lesion excisionMedicare rate & RVUs in Illinois
Excision of a malignant skin lesion with margins from the scalp, neck, hands, feet, or genitalia when the excised diameter is 0.6–1 cm.
Medicare pays $219.70–$240.08 for 11621 in the office in Illinois, from Rest Of Illinois to Chicago. 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 11621 covers
This service removes a malignant skin lesion with margins from the scalp, neck, a hand, a foot, or genital skin. Dermatologists, plastic surgeons, and other qualified physicians commonly perform it in an office procedure room or operating setting, with tissue sent for histopathology. Select 11621 when the excised diameter, including the lesion and margins, is 0.6 through 1.0 cm.
Document the anatomic site, malignant diagnosis, lesion dimensions, margin width, and resulting excised diameter. Routine wound closure is included; a separately performed intermediate or complex repair may be reported with the appropriate repair code. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the others at 50%. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, 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 11621 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$219.70 to $240.08
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $240.08 | $140.38 |
| East St. Louis | $224.38 | $133.11 |
| Rest Of Illinois | $219.70 | $129.13 |
| Suburban Chicago | $239.25 | $137.37 |
How the 11621 rate is calculated
Each of 11621’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 · 11621
RVUs × geographic indexes × conversion factor
Work2.03
2.03 RVUs× 1.000 GPCI
Practice expense4.57
4.57 RVUs× 1.000 GPCI
Malpractice0.24
0.24 RVUs× 1.000 GPCI
Adjusted RVUs
6.8400
Conversion factor
$33.4009
Medicare rate
$228.46
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11621
11621 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11621
Skin 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 · 11621
Skin 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
11621 without 51 · national office
$228.46
Skin lesion excision
11621-51 · Second procedure: 50%
$114.23
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%).
11621 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 11620Skin excision
- Both cover the same anatomic group, but 11620 is for an excised diameter of 0.5 cm or less; 11621 is for 0.6–1.0 cm.
- 11622Skin lesion excision
- Both cover the same anatomic group, but 11622 begins at 1.1 cm. Use 11621 for an excised diameter through 1.0 cm.
- 11601Malignant skin excision
- The size range is the same, but 11601 applies to the trunk or extremities rather than the scalp, neck, hands, feet, or genitalia.
- 11641Malignant lesion excision
- The size range is the same, but 11641 applies to the face, ears, eyelids, nose, or lips.
11621 billing questions
How is the 0.6–1 cm size determined?
Use the excised diameter, including the lesion and the margins taken for removal—not just the visible lesion measurement. The documented diameter must fall from 0.6 through 1.0 cm.
When should 11620 or 11622 be used instead?
Those codes are in the same anatomic group for smaller or larger excised diameters. Use 11620 for up to 0.5 cm and 11622 for 1.1–2 cm.
Can the repair be billed separately?
Routine closure is included in the excision. A separately performed intermediate or complex repair may be reported with the appropriate repair code.
Should modifier 50 be appended for paired sites?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the documented excisions according to the applicable coding rules.
Are postoperative visits separately billable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
Can an assistant surgeon or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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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