How much does Medicare pay for CPT 11643?

Medicare allowed an average of $186.77 per service and paid $145.86 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $756.59, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11643?

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm. It was billed 8,216 times to 7,392 Medicare beneficiaries by 306 providers in 2024.

Does 11643 pay differently in an office than a hospital?

Yes. The allowed amount averaged $201.77 in an office setting and $118.52 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 11643 most?

Dermatology, with 5,054 services from 180 clinicians. Next are Plastic and Reconstructive Surgery, Ambulatory Surgical Center, Otolaryngology.

CPT 11643

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm

$186.77Medicare-allowed amount per service, averaged across 8,216 services

Providers submitted

$756.59

Asking price, not received

Medicare allowed

$186.77

The fee schedule figure

Medicare paid

$145.86

Balance is patient coinsurance

Providers submitted an average of $756.59 for this code and Medicare allowed $186.77 — 4.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $145.86 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $201.77
Hospital / facility: $118.52

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 6,736 services were billed in an office setting and 1,480 in a facility.

Services: 8,216
Beneficiaries: 7,392
Providers billing it: 306
Total allowed: $1,534,502

What Medicare pays for CPT 11643

Across 8,216 services billed by 306 providers to 7,392 beneficiaries, Medicare allowed an average of $186.77 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 11643

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	5,054	4,527	$203.20	180
Plastic and Reconstructive Surgery	1,612	1,450	$166.50	62
Ambulatory Surgical Center	566	508	$88.05	19
Otolaryngology	411	381	$179.29	19
Physician Assistant	204	187	$197.57	7
Micrographic Dermatologic Surgery	107	100	$245.43	7
General Surgery	70	66	$191.99	3
Undefined Physician type	53	47	$131.37	1
Nurse Practitioner	48	47	$240.86	3
Ophthalmology	27	27	$125.15	1
Surgical Oncology	26	24	$167.37	2
Internal Medicine	21	14	$327.34	1
Physical Medicine and Rehabilitation	17	14	$148.56	1

11643 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	1,461	$201.25	$143.07	53
South Carolina	787	$170.17	$118.13	13
Texas	751	$196.52	$141.46	27
California	598	$219.83	$153.83	28
Georgia	564	$136.03	$110.82	14
Pennsylvania	401	$200.56	$147.78	17
Illinois	318	$235.49	$158.39	17
New York	264	$187.88	$137.79	10
Indiana	257	$138.54	$116.86	9
Kentucky	238	$177.52	$122.98	5
Maryland	206	$195.56	$151.21	7
Wyoming	188	$110.51	$88.23	4
Mississippi	187	$173.22	$124.14	10
Tennessee	145	$176.63	$138.39	7
Nebraska	144	$135.86	$113.79	3
Virginia	143	$211.02	$167.67	8
Iowa	134	$138.74	$118.24	5
Idaho	131	$205.39	$169.27	4
West Virginia	122	$227.47	$158.04	4
Massachusetts	122	$186.87	$135.40	5
Alabama	110	$215.01	$179.14	4
North Carolina	102	$170.03	$128.86	5
Arizona	97	$183.79	$146.66	6
Louisiana	81	$225.46	$141.99	5
Oregon	67	$226.81	$179.13	3
District of Columbia	66	$176.76	$123.31	1
Ohio	55	$161.01	$114.98	4
Colorado	51	$194.18	$146.81	3
Connecticut	49	$201.44	$154.37	2
Wisconsin	46	$219.22	$186.13	3
Washington	42	$288.93	$207.53	3
Arkansas	41	$157.40	$133.36	2
Nevada	38	$157.78	$126.48	1
Missouri	33	$130.57	$106.18	2
New Jersey	32	$158.20	$120.45	2
Oklahoma	27	$207.75	$169.07	2
Delaware	26	$154.43	$123.40	1
Michigan	25	$247.18	$167.27	2
Vermont	24	$142.30	$109.01	2
Minnesota	19	$215.55	$171.68	1
North Dakota	12	$145.67	$123.36	1
Kansas	12	$125.10	$117.93	1

Related codes

11602Removal of cancer skin growth of body$124.23
11603Removal of cancer skin growth of body$145.33
11642Removal of cancer skin growth of face$146.34
11622Removal of cancer skin growth of scalp$140.18
11604Removal of cancer skin growth of body$207.87
11606Removal of cancer skin growth of body$351.85
11641Removal of cancer skin growth of face$146.08
11623Removal of cancer skin growth of scalp$165.51
11601Removal of cancer skin growth of body$150.65
11644Removal of cancer skin growth of face$292.35
11646Removal of cancer skin growth of face$427.86
11621Removal of cancer skin growth of scalp$153.64

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.