Billing code 11641: Malignant lesion excisionMedicare rate & RVUs in Illinois
Excision of a malignant lesion on the face, ear, eyelid, nose, or lip, selected when the lesion plus margins measures 0.6–1.0 cm.
Medicare pays $228.32–$249.68 for 11641 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 11641 covers
This code covers surgical removal of a malignant skin lesion on the face, ear, eyelid, nose, or lip. Dermatologists, plastic surgeons, and other qualified physicians commonly perform the procedure in an office or outpatient setting. The size category is based on the lesion together with the margins removed, not the lesion alone. Simple closure is part of the excision service; a separately performed intermediate or complex repair may be reported when supported by the documentation.
Document the malignant lesion, exact site, and excised diameter including margins. The procedure has a 10-day global period, so related postoperative visits during that period are included. 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 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service, 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 11641 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
$228.32 to $249.68
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $249.68 | $146.62 |
| East St. Louis | $233.34 | $139.00 |
| Rest Of Illinois | $228.32 | $134.70 |
| Suburban Chicago | $248.60 | $143.29 |
How the 11641 rate is calculated
Each of 11641’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 · 11641
RVUs × geographic indexes × conversion factor
Work2.12
2.12 RVUs× 1.000 GPCI
Practice expense4.72
4.72 RVUs× 1.000 GPCI
Malpractice0.26
0.26 RVUs× 1.000 GPCI
Adjusted RVUs
7.1000
Conversion factor
$33.4009
Medicare rate
$237.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11641
11641 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11641
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 · 11641
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
11641 without 51 · national office
$237.15
Malignant lesion excision
11641-51 · Second procedure: 50%
$118.58
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%).
11641 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 11640Lesion excision
- Both cover malignant lesions in the face, ear, eyelid, nose, or lip site group. Choose 11640 when the lesion plus margins falls in the smaller size category.
- 11642Skin lesion excision
- This is the next larger size category for the same site group. Select between the codes using the documented excised diameter, including margins.
- 11601Malignant skin excision
- This code applies to malignant-lesion excision on the trunk, extremities, or other specified sites, rather than the face, ear, eyelid, nose, or lip.
- 11621Skin lesion excision
- This belongs to the malignant-lesion excision group for scalp, neck, hands, feet, or genitalia. Use 11641 for the face, ear, eyelid, nose, or lip site group.
11641 billing questions
How is this code distinguished from 11640 or 11642?
Use 11641 for the face, ear, eyelid, nose, or lip when the lesion plus margins measures 0.6–1.0 cm. Code 11640 is for the smaller size category, while 11642 is for the next larger category.
Which size should be documented?
Document the excised diameter, including the lesion and the margins removed. Do not select the size category from the lesion diameter alone.
Can a repair be billed separately?
Simple closure is included in the excision service. A separately performed intermediate or complex repair may be reported when documented and supported.
Are postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
What applies 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 for this code.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this procedure. 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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