CPT 11604

Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm

CPT 11604 pays $310.96 in a non-facility setting and $181.03 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $277.07 in Arkansas to $369.20 in Alaska, a 33% spread.

National non-facility rate

$310.96

Office and other outpatient settings

Facility rate
$181.03

Hospital and ASC settings

Highest state
$369.20

Alaska

Lowest state
$277.07

Arkansas · 33% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $310.96
CPT 11604 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $310.96, national facility $181.03.
StateRate compared visuallyNon-facilityFacility
Alaska
$369.20$230.83
District of Columbia
$352.65$199.59
California
$344.17$190.43
New York
$343.13$198.18
New Jersey
$341.87$195.57
Washington
$338.61$190.49
Massachusetts
$335.82$189.84
Hawaii
$331.97$184.24
Connecticut
$330.80$190.87
Florida
$324.26$193.90
Colorado
$321.72$183.47
Maryland
$321.60$186.15
Oregon
$318.49$181.61
Rhode Island
$317.90$183.68
New Hampshire
$317.26$182.01
Illinois
$316.93$191.39
Puerto Rico
$312.90$181.54
Virgin Islands
$312.90$181.54
Montana
$310.94$181.01
Nevada
$308.93$178.87
Pennsylvania
$308.83$181.56
Delaware
$307.80$179.43
Texas
$307.57$179.65
Wyoming
$307.49$177.56
Minnesota
$307.19$173.50
Georgia
$304.80$180.85
Michigan
$304.55$182.54
Virginia
$303.73$176.01
North Dakota
$303.03$173.10
Arizona
$303.01$177.11
Vermont
$302.42$173.79
South Dakota
$302.09$172.16
Utah
$297.94$175.80
New Mexico
$297.51$178.37
Maine
$297.32$173.17
Missouri
$294.75$175.52
Louisiana
$294.68$176.05
South Carolina
$294.18$174.13
Ohio
$294.16$175.53
Wisconsin
$293.55$169.08
North Carolina
$293.11$171.89
West Virginia
$291.26$178.35
Indiana
$289.90$169.46
Idaho
$288.37$168.83
Kentucky
$288.25$172.74
Nebraska
$287.68$167.76
Oklahoma
$287.18$171.16
Tennessee
$287.09$168.98
Iowa
$286.38$167.50
Kansas
$285.67$168.22
Alabama
$280.86$167.18
Mississippi
$280.45$168.59
Arkansas
$277.07$165.46

Billed by 1 specialties

Commercial rates for 11604

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates