$313.56
Both codes cover the scalp, neck, hands, feet, and genitalia. Choose 11624 for an excised diameter of 3.1 to 4 cm; 11626 is for greater than 4 cm.
On this page
CMS RVU26D · Effective 2026-10-01
11626 Skin excision Medicare reimbursement rates in Nebraska
Excision of a malignant skin lesion on the scalp, neck, hands, feet, or genitalia, with margins producing an excised diameter greater than 4 cm. Compare 11626 office and facility rates across CMS payment localities in Nebraska.
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 11626 in Nebraska?
Nebraska 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
$384.62
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$232.32
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 11626: Malignant skin lesion excision, over 4 cm
Excision of a malignant skin lesion on the scalp, neck, hands, feet, or genitalia, with margins producing an excised diameter greater than 4 cm.
This service removes a malignant skin lesion through the dermis, including the margins needed for excision. The site must be the scalp, neck, hand, foot, or genitalia, and the excised diameter must exceed 4 cm. Dermatologists, plastic surgeons, and other clinicians performing skin surgery commonly provide it in office or outpatient settings. Simple closure is included; intermediate or complex repair may be separately reported when performed and documented. The excised tissue is typically submitted for pathologic examination.
Choose the code by the anatomic site and the greatest excised diameter, measured as the lesion plus the margins removed. Document the lesion, site, measurements, margins, and procedure. The 10-day global period includes related postoperative visits during that period. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and reduces the others. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 11626
- 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 RVU4.49 · 36%
- Practice expense (office) RVU7.30 · 58%
- Malpractice RVU0.76 · 6%
7.2K
Medicare services in 2024 · #1641 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.
11626 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$425.19
This code covers malignant lesions over 4 cm on the trunk, arms, or legs. Code 11626 is for the scalp, neck, hands, feet, or genitalia.
$474.09
This code covers malignant lesions over 4 cm on the face, ears, eyelids, nose, or lips. Code 11626 covers the scalp, neck, hands, feet, or genitalia.
Compare 11626 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
Nebraska →
Office / nonfacility
$384.62
Facility
$232.32
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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 11626 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
1,352
- Code
- 11626
- Physician work
- 4.49
- Practice expense
- 7.30
- Malpractice
- 0.76
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.49 | × 1.000 | 4.4900 |
| Practice expense | 7.30 | × 0.923 | 6.7379 |
| Malpractice | 0.76 | × 0.378 | 0.2873 |
| Total RVUs | 11.5152 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$384.62
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.49 | 1 |
| Practice expense | 7.3 | 0.923 |
| Malpractice | 0.76 | 0.378 |
(4.49 × 1 + 7.3 × 0.923 + 0.76 × 0.378) × $33.4009 = $384.62
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.49 | 1 |
| Practice expense | 2.36 | 0.923 |
| Malpractice | 0.76 | 0.378 |
(4.49 × 1 + 2.36 × 0.923 + 0.76 × 0.378) × $33.4009 = $232.32
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.
11626 billing questions
How is the greater-than-4-cm size determined?
Use the excised diameter, including the margins removed, rather than the lesion diameter alone. The measurement must be greater than 4 cm.
When is 11624 more appropriate?
Use 11624 for the same site group when the excised diameter is 3.1 to 4 cm. Code 11626 requires a diameter greater than 4 cm.
Is simple closure separately billable?
Simple closure is included in the excision service. A separately performed intermediate or complex repair may be reported when supported by the operative documentation.
Should modifier 50 be used for lesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the excision according to the documented lesion, site, and size.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing 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 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.
1,34911622,,Exc s/n/h/f/g mal+mrg 1.1-2,A,,2.35,4.87,,1.70,,0.26,7.48,4.31,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,35011623,,Exc s/n/h/f/g mal+mrg 2.1-3,A,,3.03,5.43,,1.91,,0.38,8.84,5.32,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,35111624,,Exc s/n/h/f/g mal+mrg 3.1-4,A,,3.53,6.15,,2.07,,0.48,10.16,6.08,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,35211626,,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
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068