$292.52–$320.92
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.
On this page
CMS RVU26D · Effective 2026-10-01
11606 Lesion excision Medicare reimbursement rates in Texas
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. Compare 11606 office and facility rates across CMS payment localities in Texas.
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 11606 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$437.11–$476.52
8 of 8 localities have a supported rate.
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.
Where 11606 pays more and less in Texas
8 payment localities
$437.11 to $476.52
Dermatology procedure
About 11606: Malignant lesion excision, trunk or extremity, over 4 cm
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.
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.
CMS billing rules for 11606
- 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 RVU4.89 · 35%
- Practice expense (office) RVU8.15 · 59%
- Malpractice RVU0.84 · 6%
28.7K
Medicare services in 2024 · #991 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.
11606 compared with similar codes
Office rates for Texas, from the same CMS release.
$395.43–$430.73
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.
$487.93–$528.40
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.
Compare 11606 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $476.52 | Facility $277.21 |
| Beaumont | Office $437.11 | Facility $265.69 |
| Brazoria | Office $456.29 | Facility $269.60 |
| Dallas | Office $460.00 | Facility $272.37 |
| Fort Worth | Office $457.64 | Facility $271.90 |
| Galveston | Office $458.18 | Facility $271.12 |
| Houston | Office $473.55 | Facility $286.49 |
| Rest Of Texas | Office $447.00 | Facility $268.23 |
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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 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.
1,34211602,,Exc tr-ext mal+marg 1.1-2 cm,A,,2.21,4.76,,1.65,,0.23,7.20,4.09,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,34311603,,Exc tr-ext mal+marg 2.1-3 cm,A,,2.75,5.19,,1.81,,0.33,8.27,4.89,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,34411604,,Exc tr-ext mal+marg 3.1-4 cm,A,,3.09,5.82,,1.93,,0.40,9.31,5.42,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,34511606,,Exc tr-ext mal+marg >4 cm,A,,4.89,8.15,,2.51,,0.84,13.88,8.24,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,3461160F,,Rvw meds by rx/dr in rcrd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,34711620,,Exc h-f-nk-sp mal+marg 0.5/<,A,,1.60,4.14,,1.46,,0.21,5.95,3.27,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,34811621,,Exc s/n/h/f/g mal+mrg 0.6-1,A,,2.03,4.57,,1.60,,0.24,6.84,3.87,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00