Home › CPT Codes › CPT 11646

CPT 11646 — Exc f/e/e/n/l mal+mrg >4 cm

CPT code 11646 (Exc f/e/e/n/l mal+mrg >4 cm) carries 6.1 work RVUs under the CMS 2026 Medicare Physician Fee Schedule. Total RVUs are 15.43 in a non-facility setting and 9.97 in a facility setting, which at the 2026 conversion factor of $33.40 works out to $515.38 and $333.01 respectively.

6.1
Work RVU
15.43
Total RVU (non-facility)
$515.38
Medicare, non-facility
$333.01
Medicare, facility
Calculate your total wRVUs →

RVU breakdown for CPT 11646

ComponentRVUsWhat it covers
Work RVU6.1Physician time, skill, effort, and stress.
Practice expense RVU (non-facility)8.38Office overhead, staff, supplies.
Practice expense RVU (facility)2.92Overhead when performed in a hospital.
Malpractice RVU0.95Professional liability cost.
Total RVU (non-facility)15.43Work + non-facility PE + malpractice.
Total RVU (facility)9.97Work + facility PE + malpractice.

How Medicare payment is calculated

Medicare multiplies total RVUs by the annual conversion factor. For CPT 11646 in 2026:

SettingTotal RVUConversion factorNational payment
Non-facility15.43$33.40$515.38
Facility9.97$33.40$333.01

These are national amounts. Actual payment is adjusted by the Geographic Practice Cost Index for your locality — check yours with the GPCI lookup.

Billing rules for CPT 11646

Global period
10-day global — minor procedure; 10 days of follow-up care included.
Multiple procedure reduction
Subject to the standard multiple-procedure reduction (100%/50%/50%…).
Bilateral surgery
Bilateral adjustment does not apply.
Assistant surgeon
Not permitted.
Co-surgeon
Not permitted unless documentation supports medical necessity.
Team surgery
Not permitted unless documentation supports medical necessity.

Related codes

Codes in the same CMS family, with their work RVU values.

11606 · 4.89 wRVU

Questions about CPT 11646

How many work RVUs is CPT 11646?

CPT 11646 is assigned 6.1 work RVUs in the CMS 2026 Medicare Physician Fee Schedule.

What does Medicare pay for CPT 11646?

At the 2026 national conversion factor of $33.40, CPT 11646 pays approximately $515.38 in a non-facility setting and $333.01 in a facility setting before geographic adjustment.

What is the global period for CPT 11646?

10-day global — minor procedure; 10 days of follow-up care included.

RVU values reflect the CMS 2026 Medicare Physician Fee Schedule (conversion factor $33.40). Payment figures are national and unadjusted for geography. Verify against the official fee schedule before using for billing.