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

Removal of a benign skin lesion on the trunk, arm, or leg when the lesion and margins measure 2.1 to 3 cm across.

CMS RVU26DEffective Oct 1, 2026One payment locality43.9K Medicare services in 2024

In Puerto Rico, Medicare pays $201.06 for 11403 in the office and $136.22 when it’s performed in a hospital or facility.

$201.06Office (non-facility)
$136.22Hospital or facility
+0.7%vs the national office rate ($199.74)

Check a contract rate as a % of Medicare · 11403 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 11403 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 11403 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 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.

How Puerto Rico compares for 11403

Across 109 of 109 payment localities, the office rate for 11403 runs from $177.13 in Arkansas to $260.61 in San Benito County, CA. Puerto Rico pays $201.06. The RVUs are the same everywhere; the geographic indexes change the dollars.

11403 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$201.06
  2. Los Angeles, CA · California$223.47+$22.41
  3. Washington, DC area · District of Columbia$227.33+$26.27
  4. Miami, FL · Florida$217.90+$16.84
  5. Chicago, IL · Illinois$211.63+$10.57
  6. Manhattan, NY · New York$229.78+$28.72
  7. Alaska · Alaska$234.44+$33.38

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

Every other payment area

11403 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$179.66$123.55
ArkansasArkansas$177.13$122.04
ArizonaArizona$194.46$132.31
Bakersfield, CACalifornia$210.24$139.96
Chico, CACalifornia$209.51$139.23
El Centro, CACalifornia$209.55$139.27
Fresno, CACalifornia$209.51$139.23
Hanford, CACalifornia$209.51$139.23

11403 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$177.13

$235.06

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

View every state and territory as a table
11403 office rate range by state
State / territoryOffice rate rangeLocalities
AK$234.441
AL$179.661
AR$177.131
AZ$194.461
CA$209.51–$260.6129
CO$207.051
CT$212.821
DC$227.331
DE$197.611
FL$198.15–$217.903
GA$187.13–$203.702
GU$214.251
HI$214.251
IA$183.521
ID$184.811
IL$192.99–$211.634
IN$185.841
KS$182.961
KY$184.421
LA$184.25–$193.112
MA$205.97–$226.802
MD$201.23–$227.333
ME$186.05–$195.472
MI$189.37–$200.862
MN$197.681
MO$181.36–$193.443
MS$179.271
MT$199.721
NC$187.911
ND$194.781
NE$184.411
NH$204.091
NJ$215.05–$225.132
NM$190.491
NV$198.471
NY$190.68–$235.595
OH$188.361
OK$183.791
OR$196.73–$213.162
PA$188.49–$207.822
PR$201.061
RI$204.311
SC$188.481
SD$194.191
TN$183.901
TX$187.30–$206.548
UT$190.991
VA$195.05–$227.332
VI$201.061
VT$194.301
WA$205.49–$231.072
WI$188.431
WV$186.101
WY$197.571

See 11403 in every payment locality

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.

How the rate is built · 11403

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.79

1.79 RVUs× 1.000 GPCI

Practice expense3.94

3.94 RVUs× 1.000 GPCI

Malpractice0.25

0.25 RVUs× 1.000 GPCI

Adjusted RVUs

5.9800

Conversion factor

$33.4009

Medicare rate

$199.74

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,312

Code
11403
Physician work
1.79
Practice expense
3.94
Malpractice
0.25

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 11403 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.79× 1.0001.7900
Practice expense3.94× 1.0113.9833
Malpractice0.25× 0.9850.2462
Total RVUs6.0196
Conversion factor× 33.4009

Office rate, Puerto Rico$201.06

Office: (1.79 × 1 + 3.94 × 1.011 + 0.25 × 0.985) × $33.4009 = $201.06

Facility: (1.79 × 1 + 2.02 × 1.011 + 0.25 × 0.985) × $33.4009 = $136.22

Open 11403 in the RVU calculator

Payment rules and modifiers for 11403

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

CMS payment indicators · 11403

Benign lesion excision, trunk or limb, 2.1–3 cm

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 11403

Benign lesion excision, trunk or limb, 2.1–3 cm

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

11403 without 51 · national office

$199.74

Benign lesion excision, trunk or limb, 2.1–3 cm

11403-51 · Second procedure: 50%

$99.87

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 11403

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

Codes related to 11403
CodeHow it relatesOffice range, Puerto Rico
Same family
11402Skin lesion excision, trunk or extremity, 1.1–2 cmSame trunk, arm, or leg sites; excised diameter is 1.1 to 2 cm.$172.22
11404Skin excision, trunk or extremity, 3.1–4 cmSame trunk, arm, or leg sites; excised diameter is 3.1 to 4 cm.$232.61
11423Skin excision, scalp, neck, hands, feet, or genitaliaSame size range, but for benign lesions on the scalp, neck, hands, feet, or genitalia.$210.08
11443Skin excision, face, 2.1 to 3 cmSame size range, but for benign lesions on the face, ears, eyelids, nose, lips, or mucous membranes.$231.57
Used instead
11603Lesion excision, trunk or limb, 2.1–3 cmExcision at the same sites and size range when the lesion is malignant.$277.97
Often billed with
12032Intermediate repair, 2.6–7.5 cm, scalp/trunk/extremitiesMay be reported with a separately documented intermediate repair of an eligible wound.$302.11

How 11403 has changed in Puerto Rico

11403 · Office / nonfacility

$201.06

Effective 2026-10-01

The base rate is $7.24 higher than on 2025-10-01, moving from $193.82 to $201.06 (3.7%).

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

    $193.82changed to$201.06

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.84 changed to 1.79
    • Practice expense RVU 3.85 changed to 3.94
    • Malpractice RVU 0.28 changed to 0.25
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $199.80changed to$193.82

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.87 changed to 3.85
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $196.54changed to$199.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $202.18changed to$196.54

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.83 changed to 3.87
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $201.29changed to$202.18

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $204.76changed to$201.29

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.80 changed to 3.83
    • Malpractice RVU 0.25 changed to 0.27
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $205.04changed to$204.76

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.75 changed to 3.80
    • Malpractice RVU 0.26 changed to 0.25

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $202.26changed to$205.04

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.46 changed to 3.75
    • Malpractice RVU 0.28 changed to 0.26
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $200.03changed to$202.26

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.37 changed to 3.46
    • Malpractice RVU 0.32 changed to 0.28
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $198.73changed to$200.03

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.35 changed to 3.37
    • Malpractice RVU 0.31 changed to 0.32

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $174.48changed to$198.73

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.29 changed to 3.35
    • Malpractice RVU 0.32 changed to 0.31
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $151.78changed to$174.48

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.27 changed to 3.29
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $152.22changed to$151.78

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.31 changed to 0.32

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $151.46changed to$152.22

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $148.15changed to$151.46

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.20 changed to 3.27
    • Malpractice RVU 0.30 changed to 0.31
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $148.27changed to$148.15

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.60 changed to 3.20
    • Malpractice RVU 0.31 changed to 0.30
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $148.27

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$201.06$136.22RVU26D
2026-07-01$201.06$136.22RVU26C
2026-04-01$201.06$136.22RVU26B
2026-01-01$201.06$136.22RVU26A
2025-10-01$193.82$148.22RVU25D
2025-07-01$193.82$148.22RVU25C
2025-04-01$193.82$148.22RVU25B
2025-01-01$193.82$148.22RVU25A
2024-10-01$199.80$150.86RVU24D
2024-07-01$199.80$150.86RVU24C
2024-04-01$199.80$150.86RVU24B
2024-03-09$199.80$150.86RVU24AR
2024-01-01$196.54$148.40RVU24A
2023-10-01$202.18$151.29RVU23D
2023-07-01$201.29$150.80RVU23C
2023-04-01$201.29$150.80RVU23B
2023-01-01$201.29$150.80RVU23A
2022-10-01$204.76$151.04RVU22D
2022-07-01$204.76$151.04RVU22C
2022-04-01$204.76$151.04RVU22B
2022-01-01$204.76$151.04RVU22A
2021-10-01$205.04$150.88RVU21D
2021-07-01$205.04$150.88RVU21C
2021-04-01$205.04$150.88RVU21B
2021-01-01$205.04$150.88RVU21A
2020-10-01$202.26$153.15RVU20D
2020-07-01$202.26$153.15RVU20C
2020-04-01$202.26$153.15RVU20B
2020-01-01$202.26$153.15RVU20A
2019-10-01$200.03$153.58RVU19D
2019-07-01$200.03$153.58RVU19C
2019-04-01$200.03$153.58RVU19B
2019-01-01$200.03$153.58RVU19A
2018-10-01$198.73$153.05RVU18D
2018-07-01$198.73$153.05RVU18C
2018-04-01$198.73$153.05RVU18B
2018-01-01$198.73$153.05RVU18AR1
2017-10-01$174.48$137.00RVU17D
2017-07-01$174.48$137.00RVU17C
2017-04-01$174.48$137.00RVU17B
2017-01-01$174.48$137.00RVU17A
2016-10-01$151.78$121.24RVU16D
2016-07-01$151.78$121.24RVU16C
2016-04-01$151.78$121.24RVU16B
2016-01-01$151.78$121.24RVU16A
2015-10-01$152.22$121.82RVU15D
2015-07-01$152.22$121.82RVU15C
2015-04-01$151.46$121.21RVU15B
2015-01-01$151.46$121.21RVU15A
2014-10-01$148.15$118.90RVU14D
2014-07-01$148.15$118.90RVU14C
2014-04-01$148.15$118.90RVU14B
2014-01-01$148.15$118.90RVU14A
2013-10-01$148.27$117.13RVU13D
2013-07-01$148.27$117.13RVU13C
2013-04-01$148.27$117.13RVU13B
2013-01-01$148.27$117.13RVU13AR

Price 11403 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

11403 billing questions

How is the size level determined?

Use the excised diameter, including the lesion and margins. The documented measurement must fall from 2.1 through 3 cm for this level.

When should 11402 or 11404 be used instead?

Use 11402 for an excised diameter of 1.1 to 2 cm and 11404 for 3.1 to 4 cm. The site must still be the trunk, arm, or leg.

Does this code include simple closure?

Simple closure is included in the excision service. A separately documented intermediate or complex repair may be reported when its requirements are met.

Can modifier 50 be reported for lesions on both sides?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Are postoperative visits billed separately during the global period?

Related postoperative visits during the 10-day global period are included in the procedure.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

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 11403PPRRVU2026_Oct_nonQPP.csv, line 1,312 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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