Billing code 11446: Skin lesion excisionMedicare rate & RVUs in Texas
Reports excision of a benign lesion on the face or related facial sites when the lesion and required margins together exceed 4 cm.
Medicare pays $377.11–$408.92 for 11446 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 11446 covers
A clinician surgically removes a benign skin lesion from the face, ear, eyelid, nose, lip, or mucous membrane. Dermatologists, plastic surgeons, and other surgeons may perform the procedure in an office or operating-room setting. The code represents a large excision in these facial locations, not a shave or destruction technique.
Choose the size level using the widest diameter of the lesion plus the margins removed; the combined excised diameter must be greater than 4 cm. Document the site, benign diagnosis, lesion size, and margins so the measured excision size is clear. Simple closure is included; a separately documented intermediate or complex repair may be reported when its criteria are met. Related postoperative visits during the 10-day global period are included. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting 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 11446 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
$377.11 to $408.92
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $408.92 | $286.30 |
| Beaumont | $377.11 | $271.64 |
| Brazoria | $392.75 | $277.89 |
| Dallas | $395.78 | $280.34 |
| Fort Worth | $393.88 | $279.60 |
| Galveston | $394.28 | $279.19 |
| Houston | $406.73 | $291.64 |
| Rest Of Texas | $385.08 | $275.09 |
How the 11446 rate is calculated
Each of 11446’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 · 11446
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.68Practice expense 6.57Malpractice 0.68
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11446
11446 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11446
Skin 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 · 11446
Skin 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
11446 without 51 · national office
$398.47
Skin lesion excision
11446-51 · Second procedure: 50%
$199.24
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%).
11446 compared with similar codes
Compare codes
11446 vs 11444 vs 11426 vs 11646: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 11444Skin excision
- Both cover benign excision at facial sites. Choose 11444 for an excised diameter of 3.1 to 4 cm; choose 11446 when it exceeds 4 cm.
- 11426Benign lesion excision
- Both represent benign excision over 4 cm, but 11426 applies to scalp, neck, hands, feet, or genitalia rather than facial sites.
- 11646Malignant lesion excision
- This is the corresponding large facial-site excision for a malignant lesion. Use 11446 for a benign lesion.
11446 billing questions
How is the size selected for this code?
Use the widest diameter of the lesion plus the margins removed, not the lesion measurement alone. The combined excised diameter must be greater than 4 cm.
When should 11444 be used instead?
Use 11444 for an excision on the same facial sites when the lesion plus margins measures 3.1 to 4 cm. A measurement over 4 cm supports 11446.
Is closure separately billable?
Simple closure is included in the excision. A distinct intermediate or complex repair may be reported separately when performed and supported by the repair documentation.
Can modifier 50 be appended for lesions on both sides?
No. The descriptor and anatomy make modifier 50 inappropriate for this code.
What postoperative care is included?
Related postoperative visits for 10 days are included in the global period. Document and evaluate separate services under the applicable reporting rules.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery reporting 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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