This is a third installment in a program to develop a method for alleviating the scale disparity in binary black hole simulations with mass ratios in the intermediate astrophysical range, where simulation cost is prohibitive while purely perturbative methods may not be adequate. The method is based on excising a “worldtube” around the smaller object, much larger than the object itself, replacing it with an analytical model that approximates a tidally deformed black hole. Previously [N. A. Wittek , Worldtube excision method for intermediate-mass-ratio inspirals: Scalar-field model in 3+1 dimensions, ] we have tested the idea in a toy model of a scalar charge in a fixed circular geodesic orbit around a Schwarzschild black hole, solving for the massless Klein-Gordon field in 3+1 dimensions on the p platform. Here we take the significant further step of allowing the orbit to evolve radiatively, in a self-consistent manner, under the effect of back-reaction from the scalar field. We compute the inspiral orbit and the emitted scalar-field waveform, showing a good agreement with perturbative calculations in the adiabatic approximation. We also demonstrate how our simulations accurately resolve postadiabatic effects (for which we do not have perturbative results). In this work we focus on quasicircular inspirals. Our implementation is publicly accessible in the p numerical relativity code. Published by the American Physical Society 2024