CPT code 11403: Benign lesion excision, trunk or limb, 2.1–3 cm2026 Medicare rate & RVUs

Medicare pays $199.74 for 11403 nationally in the office and $135.61 in a hospital or facility. Local office rates run $177.13–$260.61.

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

What 11403 covers

A clinician excises a benign skin lesion from the trunk, an arm, or a leg, removing the lesion with a margin of surrounding tissue. The service is commonly performed by dermatologists, surgeons, and primary care clinicians in an office or outpatient setting. The code is selected by the excised diameter, including the margins, rather than the lesion’s size alone. For example, a small lesion may fall into this size level when the planned margins bring the total excision diameter into the 2.1-to-3-cm range.

The note should identify the lesion’s site and benign status, and document the excised diameter including margins. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

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.

Where 11403 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

11403 rates by state

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

How the 11403 rate is calculated

Each of 11403’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.

Payment rules and modifiers for 11403

11403 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

11403 compared with similar codes

How to choose

11402Skin lesion excisionTrunk or extremity, 1.1–2 cm

This code applies when the excised diameter, including margins, is 2.1 to 3 cm; 11402 is for 1.1 to 2 cm at the same sites.

11404Skin excisionTrunk or extremity, 3.1–4 cm

This code covers 2.1 to 3 cm; 11404 applies to 3.1 to 4 cm at the same sites.

11423Skin excisionScalp, neck, hands, feet, or genitalia

The size range is the same, but 11423 is for the scalp, neck, hands, feet, or genitalia rather than the trunk, arms, or legs.

11603Lesion excisionTrunk or limb, 2.1–3 cm

Use 11603 for a malignant lesion at the same sites and size range; 11403 is for a benign lesion.

Codes related to 11403

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates