$239.03–$270.01
Both cover malignant lesions in the same site group; 11641 applies when the excised diameter is 0.6–1 cm rather than 1.1–2 cm.
On this page
CMS RVU26D · Effective 2026-10-01
11642 Skin lesion excision Medicare reimbursement rates in Maryland
Report this code for excision of a malignant skin lesion on the face, ear, eyelid, nose, or lip when the excised diameter is 1.1–2 cm. Compare 11642 office and facility rates across CMS payment localities in Maryland.
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 11642 in Maryland?
Maryland has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$268.96–$303.16
3 of 3 localities have a supported rate.
Facility setting
$155.39–$170.96
3 of 3 localities have a supported rate.
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.
Where 11642 pays more and less in Maryland
3 payment localities
$268.96 to $303.16
Dermatology procedure
About 11642: Malignant skin lesion excision, face, 1.1–2 cm
Report this code for excision of a malignant skin lesion on the face, ear, eyelid, nose, or lip when the excised diameter is 1.1–2 cm.
This code covers conventional excision of a malignant skin lesion on the face, ears, eyelids, nose, or lips. Dermatologists, plastic surgeons, and other qualified clinicians commonly perform the procedure in an office or outpatient setting. The excision removes the lesion with the margins needed for the planned treatment; it is distinct from Mohs surgery. Simple closure is included, while a separately reportable intermediate or complex repair may be coded when its requirements are met.
Choose the code by the anatomic site group and the excised diameter: the lesion’s greatest diameter plus the narrowest margins removed. Document the diagnosis, exact site, lesion and margin measurements, and closure performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. CMS does not pay an assistant at surgery for this service and does not permit co-surgeon or team-surgery billing.
CMS billing rules for 11642
- 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 RVU2.55 · 32%
- Practice expense (office) RVU5.14 · 64%
- Malpractice RVU0.30 · 4%
54.7K
Medicare services in 2024 · #751 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.
11642 compared with similar codes
Office rates for Maryland, from the same CMS release.
$318.19–$357.49
This code is for an excised diameter of 1.1–2 cm; 11643 is for 2.1–3 cm at the same sites.
$242.50–$273.64
The size range is the same, but 11602 applies to the trunk, arms, or legs rather than the face, ears, eyelids, nose, or lips.
$251.86–$284.01
The size range is the same, but 11622 applies to the scalp, neck, hands, feet, or genitalia.
Compare 11642 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.
3 of 3 payment localities
Baltimore/Surr. Cntys →
Office / nonfacility
$283.14
Facility
$162.72
Dc + Md/Va Suburbs →
Office / nonfacility
$303.16
Facility
$170.96
Rest Of Maryland →
Office / nonfacility
$268.96
Facility
$155.39
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11642 billing questions
How is the 1.1–2 cm size determined?
Use the excised diameter: the lesion’s greatest diameter plus the narrowest margins removed. Document the measurements that support the selected size range.
Does the code include closing the wound?
Simple closure is included. An intermediate or complex repair may be separately reported when supported by the repair documentation and applicable coding requirements.
When should 11641 be used instead?
Use 11641 for the same anatomic site group when the excised diameter is 0.6–1 cm. The size is based on the lesion and margins, not the length of the closure.
Does the 10-day global period include wound checks?
Related postoperative visits during the 10-day global period are included in this procedure.
What happens if another procedure is performed in the same session?
The highest-valued procedure is paid in full, and the other procedures are subject to the standard multiple-procedure reduction.
Can an assistant surgeon or co-surgeon be billed?
CMS does not pay an assistant at surgery for this service and does not permit co-surgeon or team-surgery billing.
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.
1,35211626,,Exc s/n/h/f/g mal+mrg >4 cm,A,,4.49,7.30,,2.36,,0.76,12.55,7.61,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,35311640,,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