Billing code 11623: Skin excisionMedicare rate & RVUs in Virginia
Surgical removal of a malignant skin lesion on the scalp, neck, hand, foot, or genital skin, selected by the total excision diameter.
Medicare pays $288.45–$334.45 for 11623 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. 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 11623 covers
This code covers surgical removal of a malignant cutaneous lesion from the scalp, neck, hand, foot, or genital skin when the total excision diameter is 2.1–3 cm. Dermatologists and other clinicians who perform skin surgery commonly report it for an outpatient excision, with the specimen typically submitted for pathologic examination. The measured diameter includes the lesion and the margins taken around it, not only the visible lesion.
Choose the code by the anatomic group and the total diameter planned for excision, and document the site, lesion measurement, margins, and resulting excision size. Simple closure is included; an intermediate or complex repair may be separately reportable when performed and documented. CMS assigns a 10-day global period, so related postoperative visits during those 10 days are included. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing 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 11623 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $334.45 | $195.95 |
| Virginia | $288.45 | $172.88 |
How the 11623 rate is calculated
Each of 11623’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 · 11623
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.03Practice expense 5.43Malpractice 0.38
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11623
11623 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11623
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 · 11623
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
11623 without 51 · national office
$295.26
Skin excision
11623-51 · Second procedure: 50%
$147.63
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%).
11623 compared with similar codes
Compare codes
11623 vs 11622 vs 11624 vs 11603 vs 11643: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 11622Skin lesion excision
- Use 11622 for the same anatomic group when the lesion and required margins total 1.1–2 cm; use 11623 when they total 2.1–3 cm.
- 11624Skin excision
- Use 11624 for the same anatomic group when the total excision diameter is 3.1–4 cm, rather than 2.1–3 cm.
- 11603Lesion excision
- The size range is the same, but 11603 is for the trunk or extremities; 11623 is for the scalp, neck, hands, feet, or genital skin.
- 11643Malignant lesion excision
- The size range is the same, but 11643 is for the face, ears, eyelids, nose, or lips.
11623 billing questions
How is the 2.1–3 cm size determined?
Use the total diameter of the lesion plus the margins required for excision, rather than the visible lesion alone. Document the lesion measurement, planned margins, site, and total excision size.
Is simple closure separately reportable?
No. Simple closure is included in the excision; an intermediate or complex repair may be separately reported when supported by the repair performed and its documentation.
Can modifier 50 be used for lesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the excisions based on the individual lesions and applicable same-session multiple-procedure rules.
How does the 10-day global period affect follow-up?
Related postoperative visits during the 10-day global period are included in the procedure payment.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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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