CPT code 11103: Tangential skin biopsy, each separate or additional lesion2026 Medicare rate & RVUs in Virginia

Report this add-on for each separate skin lesion sampled tangentially beyond the lesion represented by the primary biopsy code at the same session.

CMS RVU26DEffective Oct 1, 2026One payment locality1.5M Medicare services in 2024

In Virginia, Medicare pays $47.78 for 11103 in the office and $17.24 when it’s performed in a hospital or facility.

$47.78Office (non-facility)
$17.24Hospital or facility
−2.0%vs the national office rate ($48.77)

Check a contract rate as a % of Medicare · 11103 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 11103 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 11103 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 11103 covers

This add-on captures a tangential sample from another distinct skin lesion during a session with a primary skin biopsy. A shave, scoop, saucerization, or curettage removes epidermis and sometimes dermis for diagnostic examination without a wedge incision. Dermatologists, primary care clinicians, nurse practitioners, and physician assistants perform these biopsies in offices or outpatient clinics when evaluating multiple suspicious lesions, such as possible basal cell carcinomas or atypical pigmented lesions. Routine hemostasis and simple closure are included.

Report one unit of 11103 for each additional lesion sampled tangentially, not for extra passes or fragments from the same lesion. For mixed methods, select the primary biopsy code by technique complexity: incisional before punch before tangential; select each add-on by its own technique. Document each lesion's location, clinical concern, sampling method, and corresponding specimen so the lesion count and technique are clear. CMS requires this add-on with a primary biopsy procedure and pays it within that procedure's global period.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Virginia compares for 11103

Across 109 of 109 payment localities, the office rate for 11103 runs from $43.17 in Arkansas to $65.01 in San Benito County, CA. Virginia pays $47.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

11103 in Virginia vs other payment areas
  1. Virginia · this page$47.78
  2. Los Angeles, CA · California$55.24+$7.46
  3. Washington, DC area · District of Columbia$55.83+$8.05
  4. Miami, FL · Florida$52.25+$4.47
  5. Chicago, IL · Illinois$50.76+$2.98
  6. Manhattan, NY · New York$56.02+$8.24
  7. Alaska · Alaska$56.62+$8.84

Other areas in Virginia first, then benchmark localities. Bars start at $0.

Every other payment area

11103 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$43.80$16.62
ArkansasArkansas$43.17$16.49
ArizonaArizona$47.49$17.39
Bakersfield, CACalifornia$51.84$17.80
Chico, CACalifornia$51.72$17.68
El Centro, CACalifornia$51.73$17.68
Fresno, CACalifornia$51.72$17.68
Hanford, CACalifornia$51.72$17.68

11103 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$43.17

$58.37

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
11103 office rate range by state
State / territoryOffice rate rangeLocalities
AK$56.621
AL$43.801
AR$43.171
AZ$47.491
CA$51.72–$65.0129
CO$50.871
CT$51.991
DC$55.831
DE$48.271
FL$47.89–$52.253
GA$45.23–$49.632
GU$53.011
HI$53.011
IA$44.981
ID$45.261
IL$46.47–$50.834
IN$45.521
KS$44.741
KY$44.761
LA$44.68–$46.882
MA$50.55–$55.932
MD$49.20–$55.833
ME$45.45–$47.962
MI$45.89–$48.452
MN$48.841
MO$43.89–$47.083
MS$43.541
MT$48.761
NC$45.931
ND$47.971
NE$45.231
NH$50.041
NJ$52.62–$55.252
NM$46.121
NV$48.581
NY$46.61–$57.335
OH$45.721
OK$44.711
OR$48.23–$52.512
PA$45.82–$50.682
PR$49.131
RI$50.011
SC$45.901
SD$47.881
TN$44.961
TX$45.51–$50.678
UT$46.521
VA$47.78–$55.832
VI$49.131
VT$47.751
WA$50.47–$57.102
WI$46.371
WV$44.751
WY$48.421

See 11103 in every payment locality

How the 11103 rate is calculated

Each of 11103’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 11103

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.37

0.37 RVUs× 1.000 GPCI

Practice expense1.05

1.05 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

1.4600

Conversion factor

$33.4009

Medicare rate

$48.77

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,271

Code
11103
Physician work
0.37
Practice expense
1.05
Malpractice
0.04

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 11103 in Virginia
ComponentRVULocality factorAdjusted
Physician work0.37× 1.0000.3700
Practice expense1.05× 0.9831.0322
Malpractice0.04× 0.7060.0282
Total RVUs1.4304
Conversion factor× 33.4009

Office rate, Virginia$47.78

Office: (0.37 × 1 + 1.05 × 0.983 + 0.04 × 0.706) × $33.4009 = $47.78

Facility: (0.37 × 1 + 0.12 × 0.983 + 0.04 × 0.706) × $33.4009 = $17.24

Open 11103 in the RVU calculator

Payment rules and modifiers for 11103

The CMS indicators that decide how 11103 is paid alongside other services.

CMS payment indicators · 11103

Tangential skin biopsy, each separate or additional lesion

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

How 11103 has changed in Virginia

11103 · Office / nonfacility

$47.78

Effective 2026-10-01

The base rate is $0.75 higher than on 2025-10-01, moving from $47.03 to $47.78 (1.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $47.03changed to$47.78

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.38 changed to 0.37
    • Practice expense RVU 1.06 changed to 1.05
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $49.38changed to$47.03

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.09 changed to 1.06

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $48.58changed to$49.38

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $50.56changed to$48.58

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755
  5. January 1, 2023

    RVU23A

    $52.27changed to$50.56

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.10 changed to 1.09
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $53.74changed to$52.27

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.13 changed to 1.10

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $53.97changed to$53.74

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.08 changed to 1.13
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $53.71changed to$53.97

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$53.71

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$47.78$17.24RVU26D
2026-07-01$47.78$17.24RVU26C
2026-04-01$47.78$17.24RVU26B
2026-01-01$47.78$17.24RVU26A
2025-10-01$47.03$20.61RVU25D
2025-07-01$47.03$20.61RVU25C
2025-04-01$47.03$20.61RVU25B
2025-01-01$47.03$20.61RVU25A
2024-10-01$49.38$21.21RVU24D
2024-07-01$49.38$21.21RVU24C
2024-04-01$49.38$21.21RVU24B
2024-03-09$49.38$21.21RVU24AR
2024-01-01$48.58$20.87RVU24A
2023-10-01$50.56$21.38RVU23D
2023-07-01$50.56$21.38RVU23C
2023-04-01$50.56$21.38RVU23B
2023-01-01$50.56$21.38RVU23A
2022-10-01$52.27$21.97RVU22D
2022-07-01$52.27$21.97RVU22C
2022-04-01$52.27$21.97RVU22B
2022-01-01$52.27$21.97RVU22A
2021-10-01$53.74$22.15RVU21D
2021-07-01$53.74$22.15RVU21C
2021-04-01$53.74$22.15RVU21B
2021-01-01$53.74$22.15RVU21A
2020-10-01$53.97$23.21RVU20D
2020-07-01$53.97$23.21RVU20C
2020-04-01$53.97$23.21RVU20B
2020-01-01$53.97$23.21RVU20A
2019-10-01$53.71$23.50RVU19D
2019-07-01$53.71$23.50RVU19C
2019-04-01$53.71$23.50RVU19B
2019-01-01$53.71$23.50RVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 11103 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

11103 billing questions

Which primary codes can this add-on be reported with?

It can be reported with 11102 for a first tangential biopsy, or with 11104 or 11106 when the primary lesion was sampled by punch or incisional technique. The primary code reflects the most intensive biopsy method performed that session.

If one lesion is punch biopsied and two are shaved, how is it coded?

Report 11104 for the punch biopsy and two units of 11103 for the two tangential biopsies. The tangential primary code 11102 is not used because a more intensive method was performed.

How is a shave biopsy distinguished from a shave removal?

A tangential biopsy samples a lesion for diagnosis; shave removal codes 11300-11313 describe removal of a lesion and are selected by site and diameter. Use the documented purpose and extent of the procedure, not specimen submission alone, to distinguish them.

Can multiple samples from the same lesion be counted as additional units?

No. Units count separate lesions, not multiple fragments or passes on one lesion. Each additional unit needs a distinct lesion with its own documented site.

Can an E/M visit be billed on the same day?

Yes, when a significant, separately identifiable evaluation beyond the usual pre-biopsy assessment is documented, using modifier 25 on the E/M code. The decision to biopsy alone does not support a separate visit.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 11103PPRRVU2026_Oct_nonQPP.csv, line 1,271 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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