Billing code 11443: Skin excisionMedicare rate & RVUs in Texas
Reports complete excision of a clinically benign lesion on the face, ears, eyelids, nose, or lips when the excised diameter is 2.1 to 3 cm.
Medicare pays $216.46–$237.49 for 11443 in the office in Texas, from Beaumont to Austin. 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 11443 covers
This service removes a lesion believed to be benign from the face, ears, eyelids, nose, or lips, including a margin of surrounding skin. Dermatologists, plastic surgeons, and other qualified clinicians commonly perform it in an office procedure room or an outpatient facility. A specimen may be submitted for histopathology, which can confirm the diagnosis; the excision code is selected based on the lesion’s clinical classification and the excised diameter, not the eventual pathology result alone.
Measure the greatest diameter of the lesion plus the narrowest margins needed for removal, and document the site, lesion size, and margins so the reported size falls within 2.1 to 3 cm. Simple closure is included; a separately reportable intermediate or complex repair may be coded based on its own criteria. The procedure has a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery 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 11443 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$216.46 to $237.49
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $237.49 | $162.57 |
| Beaumont | $216.46 | $152.03 |
| Brazoria | $227.24 | $157.07 |
| Dallas | $228.82 | $158.29 |
| Fort Worth | $227.51 | $157.69 |
| Galveston | $228.01 | $157.70 |
| Houston | $233.50 | $163.19 |
| Rest Of Texas | $221.82 | $154.62 |
How the 11443 rate is calculated
Each of 11443’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 · 11443
RVUs × geographic indexes × conversion factor
Work2.28
2.28 RVUs× 1.000 GPCI
Practice expense4.31
4.31 RVUs× 1.000 GPCI
Malpractice0.30
0.30 RVUs× 1.000 GPCI
Adjusted RVUs
6.8900
Conversion factor
$33.4009
Medicare rate
$230.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11443
11443 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11443
Skin 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 · 11443
Skin 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
11443 without 51 · national office
$230.13
Skin excision
11443-51 · Second procedure: 50%
$115.07
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%).
11443 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 11442Facial lesion excision
- Use 11442 for a benign lesion at the same facial sites when the excised diameter is 1.1 to 2 cm; use 11443 when it is 2.1 to 3 cm.
- 11444Skin excision
- Use 11444 for the same type of benign facial lesion excision when the excised diameter is 3.1 to 4 cm.
- 11423Skin excision
- The size range and benign-lesion excision method are similar, but 11423 is for scalp, neck, hands, feet, or genitalia rather than the face and related sites.
- 11643Malignant lesion excision
- Use 11643 for excision of a lesion treated as malignant at these facial sites and in this size range; 11443 is for lesions treated as benign.
11443 billing questions
How is the size range determined?
Use the greatest diameter of the lesion together with the narrowest margins required for excision. The documented excised diameter must be 2.1 to 3 cm.
Can the closure be billed separately?
Simple closure is included in the excision. A qualifying intermediate or complex repair may be separately reported using the repair code that matches its complexity, site, and length.
Does a pathology result showing malignancy change this code?
The excision code is chosen based on the lesion’s clinical classification when removed. If the lesion is treated as malignant rather than benign, use the applicable malignant-lesion excision code instead.
Should modifier 50 be appended for lesions on both sides of the face?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What postoperative care is included?
Related postoperative visits during the 10-day global period are included in the procedure.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a reduction. Assistant-at-surgery payment is restricted, and 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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