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See a sample rate comparisonCPT 11626 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Excision Malignant Lesion Sc, Excision Malignant Lesion Scalp Neck Hands Feetgenitalia Lesion Diameter Over 4.0 Cm Excision Malignant Lesion Scalp Neck Hands Feet
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 11626 |
| Medicaid Fee Schedule | View Medicaid rates for 11626 |
National average reimbursement for CPT 11626 by major payers:
$434.36
$513.83
$528.45
$480.49
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CPT 11626
5 of 25 sample ratesHigher to lower in this preview
Hudson Crossing Surgery Center, LLC, Hudson Crossing Surgery Center
Hudson Crossing Surgical Center
$6,000.00Published rateBear Creek Surgery Center, LLC
$2,256.00Published rateShadelands Advanced Endoscopy Institute, Inc.
Shadelands Advanced Endoscopy Institute Inc
$1,526.00Published rateParkway Surgical Center, LLC
Parkway Surgical Center LLC
$935.00Published rateGastroenterology & Hepatology Consultants, PA, Wake Forest Endoscopy Center
Gastroenterology And Hepatology Consultants, P.A.
$839.00Published rate
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See a sample payer proposalCPT 11626 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11626 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 11626 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 11622-CPT | Moderate | Excision Malignant Lesion Sc, Excision Malignant Lesion Scalp Neck Hands Feetgenitalia Lesion Diameter 1.1 To 2.0 Cm Excision Malignant Lesion Scalp Neck Hands Feet |
| 11623-CPT | Moderate | Excision Malignant Lesion Sc, Excision Malignant Lesion Scalp Neck Hands Feetgenitalia Lesion Diameter 2.1 To 3.0 Cm Excision Malignant Lesion Scalp Neck Hands Feet |
| 11624-CPT | Moderate | Excision Malignant Lesion Sc, Excision Malignant Lesion Scalp Neck Hands Feetgenitalia Lesion Diameter 3.1 To 4.0 Cm Excision Malignant Lesion Scalp Neck Hands Feet |
| 11626-CPT | Moderate | Excision Malignant Lesion Sc, Excision Malignant Lesion Scalp Neck Hands Feetgenitalia Lesion Diameter Over 4.0 Cm Excision Malignant Lesion Scalp Neck Hands Feet |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11626. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11626 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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