$360.77
This code is for the same facial and related sites when the excised diameter exceeds 4 cm; 11644 applies through 4 cm.
On this page
CMS RVU26D · Effective 2026-10-01
11646 Malignant lesion excision Medicare reimbursement rates in Kansas
Reports surgical removal of a malignant skin lesion on the face or related sites when the excised diameter, including margins, exceeds 4 cm. Compare 11646 office and facility rates across CMS payment localities in Kansas.
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 11646 in Kansas?
Kansas 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
$472.77
1 of 1 localities have a supported rate.
Payment area: Kansas
One mapped payment locality.
Facility setting
$307.91
1 of 1 localities have a supported rate.
Payment area: Kansas
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 11646: Large malignant lesion excision, face
Reports surgical removal of a malignant skin lesion on the face or related sites when the excised diameter, including margins, exceeds 4 cm.
This code covers excision of a malignant skin lesion from the face, ear, eyelid, nose, or lip, with the surrounding margin of tissue. Dermatologists, plastic surgeons, and other qualified surgeons may perform it in an office or outpatient surgical setting. It describes excision rather than Mohs micrographic surgery, which uses a separate technique and code family.
Select the code by anatomical site and the diameter of the excised area, including margins—not the visible lesion alone. Document the lesion dimensions, margins taken, final excised diameter, site, and malignancy. Simple closure is included; a separately documented intermediate or complex repair may be reported when appropriate. CMS assigns a 10-day global period, including related postoperative visits during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. CMS does not pay an assistant at surgery, and does not permit co-surgeons or team surgery for this service.
CMS billing rules for 11646
- 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 RVU6.10 · 40%
- Practice expense (office) RVU8.38 · 54%
- Malpractice RVU0.95 · 6%
6.9K
Medicare services in 2024 · #1671 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.
11646 compared with similar codes
Office rates for Kansas, from the same CMS release.
$423.56
Both cover malignant-lesion excision over 4 cm, but 11606 is for the trunk, arms, or legs rather than the face and related sites.
$383.18
Both cover malignant-lesion excision over 4 cm, but 11626 is for the scalp, neck, hands, feet, or genitalia.
$614.50
Use 11646 for excision without Mohs staging; 17311 describes the first stage of Mohs surgery with microscopic examination of tissue margins.
Compare 11646 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
Kansas →
Office / nonfacility
$472.77
Facility
$307.91
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 11646 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
1,358
- Code
- 11646
- Physician work
- 6.10
- Practice expense
- 8.38
- Malpractice
- 0.95
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.10 | × 1.000 | 6.1000 |
| Practice expense | 8.38 | × 0.904 | 7.5755 |
| Malpractice | 0.95 | × 0.504 | 0.4788 |
| Total RVUs | 14.1543 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kansas$472.77
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.1 | 1 |
| Practice expense | 8.38 | 0.904 |
| Malpractice | 0.95 | 0.504 |
(6.1 × 1 + 8.38 × 0.904 + 0.95 × 0.504) × $33.4009 = $472.77
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.1 | 1 |
| Practice expense | 2.92 | 0.904 |
| Malpractice | 0.95 | 0.504 |
(6.1 × 1 + 2.92 × 0.904 + 0.95 × 0.504) × $33.4009 = $307.91
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.
11646 billing questions
When should 11646 be selected instead of 11644?
Use 11646 for an excised diameter greater than 4 cm at the face, ear, eyelid, nose, or lip. Code 11644 covers the same sites when the excised diameter is 3.1 to 4 cm.
Is the measurement based on the visible lesion?
No. Select the size level using the excised diameter, including the margins. Document the lesion size, margin taken, and resulting excised diameter.
Can the repair be billed separately?
Simple closure is included. A separately documented intermediate or complex repair may be reported when the repair meets the requirements for that service.
Does modifier 50 apply to lesions on both sides of the face?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Related postoperative visits are included in this code's 10-day global period.
Can an assistant or co-surgeon be billed for this excision?
CMS does not pay an assistant at surgery for this code and does not permit co-surgeons or team surgery.
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.
1,35511642,,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
1,36011719,,Trim nail(s) any number,R,,0.17,0.25,,0.02,,0.01,0.43,0.20,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,36111720,,Debride nail 1-5,A,,0.31,0.64,,0.04,,0.03,0.98,0.38,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958