Billing code 11606: Lesion excisionMedicare rate & RVUs in Oregon
Excision of a malignant skin lesion on the trunk, arm, or leg is reported when the lesion and required margins produce an excised diameter greater than 4 cm.
Medicare pays $454.18–$489.25 for 11606 in the office in Oregon, from Rest Of Oregon to Portland. 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 11606 covers
This code covers surgical removal of a malignant skin lesion from the trunk, an arm, or a leg when the excised diameter, including the margins, is greater than 4 cm. Dermatologists, general surgeons, and other qualified physicians may perform the procedure in an office or surgical setting. The removed tissue is typically submitted for pathologic examination; closure is based on the resulting defect and may involve a separate repair service when the closure is intermediate or complex.
Choose the code by the anatomic site and the excised diameter, not the lesion’s appearance alone. Documentation should identify the site and diagnosis, describe the lesion dimensions and margins, and support the final excised diameter. Simple closure is included. A 10-day global period includes related postoperative visits during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery services 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 11606 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $489.25 | $279.96 |
| Rest Of Oregon | $454.18 | $266.56 |
How the 11606 rate is calculated
Each of 11606’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 · 11606
RVUs × geographic indexes × conversion factor
Work4.89
4.89 RVUs× 1.000 GPCI
Practice expense8.15
8.15 RVUs× 1.000 GPCI
Malpractice0.84
0.84 RVUs× 1.000 GPCI
Adjusted RVUs
13.8800
Conversion factor
$33.4009
Medicare rate
$463.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11606
11606 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11606
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 · 11606
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
11606 without 51 · national office
$463.60
Lesion excision
11606-51 · Second procedure: 50%
$231.80
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%).
11606 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 11604Malignant excision
- Both codes cover malignant lesions on the trunk, arms, or legs. Choose 11604 for an excised diameter of 3.1–4 cm; choose 11606 when it is greater than 4 cm.
- 11626Skin excision
- Both use the greater-than-4-cm size category, but 11626 is for scalp, neck, hands, feet, or genitalia. Use 11606 for the trunk, arms, or legs.
- 11646Malignant lesion excision
- Both use the greater-than-4-cm size category, but 11646 is for the face, ears, eyelids, nose, or lips. Use 11606 for the trunk, arms, or legs.
11606 billing questions
How is the size threshold determined?
Use the excised diameter, including the margins, rather than the lesion diameter alone. This code applies when that measurement is greater than 4 cm.
When should 11604 be used instead?
Use 11604 for a malignant lesion on the trunk, arm, or leg with an excised diameter of 3.1–4 cm. The site is the same; the size category differs.
Is closure separately reportable?
Simple closure is included in the excision. An intermediate or complex repair may be separately reported when the repair performed and its documentation support that service.
Can modifier 50 be used for lesions on both sides?
No. Modifier 50 is inappropriate for this code. Follow the applicable reporting rules for each procedure performed.
What postoperative care is included?
Related postoperative visits during the 10-day global period are included in the procedure payment.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment is restricted; 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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