$223.50
Use 11641 for the same facial sites when the excised diameter is 0.6–1 cm; 11640 is limited to 0.5 cm or less.
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CMS RVU26D · Effective 2026-10-01
11640 Lesion excision Medicare reimbursement rates in Ohio
Reports excision of a malignant skin lesion on the face or specified facial sites when the lesion and required margins measure 0.5 cm or less. Compare 11640 office and facility rates across CMS payment localities in Ohio.
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 11640 in Ohio?
Ohio 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
$190.17
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$106.61
1 of 1 localities have a supported rate.
Payment area: Ohio
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 11640: Small facial malignant lesion excision
Reports excision of a malignant skin lesion on the face or specified facial sites when the lesion and required margins measure 0.5 cm or less.
This code covers removal of a malignant skin lesion from the face, ear, eyelid, nose, or lip, with the margins needed for excision. Dermatologists, plastic surgeons, and other qualified physicians commonly perform the procedure in an office or outpatient surgical setting. The size category is based on the excised diameter, including the lesion and margins—not the lesion alone. The code includes simple closure; a separately performed intermediate or complex repair may be reported when supported by the service and documentation.
Choose this code when the anatomic site is one of the specified facial sites and the excised diameter is 0.5 cm or less. Document the lesion’s location and size, the margins taken, and the resulting excised diameter; retain pathology findings supporting the malignant diagnosis. CMS assigns a 10-day global period, so related postoperative visits during that period are included. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 11640
- 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 RVU1.63 · 27%
- Practice expense (office) RVU4.23 · 70%
- Malpractice RVU0.20 · 3%
3.8K
Medicare services in 2024 · #2028 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.
11640 compared with similar codes
Office rates for Ohio, from the same CMS release.
$186.43
This code is for the specified facial sites. Code 11600 is the corresponding small-lesion category for specified trunk and extremity sites.
$186.76
This code covers specified facial sites; 11620 is the small-lesion category for specified scalp, neck, hand, foot, and genital sites.
Compare 11640 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
Ohio →
Office / nonfacility
$190.17
Facility
$106.61
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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 11640 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
1,353
- Code
- 11640
- Physician work
- 1.63
- Practice expense
- 4.23
- Malpractice
- 0.20
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.63 | × 1.000 | 1.6300 |
| Practice expense | 4.23 | × 0.913 | 3.8620 |
| Malpractice | 0.20 | × 1.008 | 0.2016 |
| Total RVUs | 5.6936 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$190.17
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.63 | 1 |
| Practice expense | 4.23 | 0.913 |
| Malpractice | 0.2 | 1.008 |
(1.63 × 1 + 4.23 × 0.913 + 0.2 × 1.008) × $33.4009 = $190.17
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.63 | 1 |
| Practice expense | 1.49 | 0.913 |
| Malpractice | 0.2 | 1.008 |
(1.63 × 1 + 1.49 × 0.913 + 0.2 × 1.008) × $33.4009 = $106.61
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.
11640 billing questions
How is the size category determined?
Use the excised diameter, including the lesion and the margins taken, rather than the lesion’s diameter alone. This code is for an excised diameter of 0.5 cm or less.
Which sites qualify for this code?
The site must be the face, ear, eyelid, nose, or lip. For the same size category on a different anatomic group, use the code assigned to that group.
Is simple closure separately reported?
Simple closure is included in the excision service. A separately performed intermediate or complex repair may be reported when its documentation supports that repair.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
What happens when multiple procedures are performed in the same session?
CMS pays the highest-valued procedure in full and applies the standard multiple procedure reduction to the other procedures.
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.
1,35011623,,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
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
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703