How much does Medicare pay for CPT 11646?

Medicare allowed an average of $427.86 per service and paid $338.20 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1335.29, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11646?

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm. It was billed 1,150 times to 898 Medicare beneficiaries by 43 providers in 2024.

Does 11646 pay differently in an office than a hospital?

Yes. The allowed amount averaged $396.96 in an office setting and $484.93 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 11646 most?

Plastic and Reconstructive Surgery, with 295 services from 13 clinicians. Next are Ophthalmology, Dermatology, Otolaryngology.

CPT 11646

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm

$427.86Medicare-allowed amount per service, averaged across 1,150 services

Providers submitted

$1335.29

Asking price, not received

Medicare allowed

$427.86

The fee schedule figure

Medicare paid

$338.20

Balance is patient coinsurance

Providers submitted an average of $1335.29 for this code and Medicare allowed $427.86 — 3.1× 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 $338.20 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $396.96
Hospital / facility: $484.93

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 746 services were billed in an office setting and 404 in a facility.

Services: 1,150
Beneficiaries: 898
Providers billing it: 43
Total allowed: $492,039

What Medicare pays for CPT 11646

Across 1,150 services billed by 43 providers to 898 beneficiaries, Medicare allowed an average of $427.86 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. 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 11646

Specialty	Services	Beneficiaries	Avg allowed	Providers
Plastic and Reconstructive Surgery	295	267	$397.88	13
Ophthalmology	238	111	$253.48	1
Dermatology	234	181	$465.03	5
Otolaryngology	204	184	$339.52	13
Ambulatory Surgical Center	105	90	$1042.76	6
Surgical Oncology	51	43	$307.60	3
Micrographic Dermatologic Surgery	12	11	$514.41	1
Family Practice	11	11	$446.49	1

11646 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	503	$383.75	$300.25	9
Georgia	125	$614.35	$504.36	4
Alabama	77	$414.17	$394.01	2
Pennsylvania	76	$429.83	$329.94	3
California	72	$555.59	$397.60	5
Maryland	56	$511.86	$405.21	4
Illinois	31	$390.68	$298.89	2
North Carolina	25	$260.73	$232.30	1
Oregon	20	$447.39	$363.35	1
Nebraska	19	$172.41	$143.04	1
Texas	17	$366.97	$302.37	1
Massachusetts	14	$314.81	$222.33	1
Arkansas	14	$318.84	$280.29	1
Michigan	14	$272.20	$183.43	1
Delaware	14	$1001.74	$777.53	1
Kentucky	13	$192.66	$162.19	1
New Jersey	13	$368.82	$266.70	1
New York	13	$560.15	$384.75	1
Missouri	12	$264.33	$214.21	1
Virginia	11	$230.79	$164.59	1
South Carolina	11	$446.49	$376.73	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
11643Removal of cancer skin growth of face$186.77
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
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.