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.
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CMS RVU26D · Effective 2026-10-01
11403 Benign lesion excision Medicare reimbursement rates
Removal of a benign skin lesion on the trunk, arm, or leg when the lesion and margins measure 2.1 to 3 cm across. Compare 11403 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 11403?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$177.13–$260.61
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $83.48 per service.
Facility setting
$122.04–$168.13
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $46.09 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 11403 pays more and less
109 payment localities
$177.13 to $260.61
Dermatology procedure
About 11403: Benign lesion excision, trunk or limb
Removal of a benign skin lesion on the trunk, arm, or leg when the lesion and margins measure 2.1 to 3 cm across.
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.
CMS billing rules for 11403
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.79 · 30%
- Practice expense (office) RVU3.94 · 66%
- Malpractice RVU0.25 · 4%
43.9K
Medicare services in 2024 · #831 by national volume
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.
11403 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
This code covers 2.1 to 3 cm; 11404 applies to 3.1 to 4 cm at the same sites.
The size range is the same, but 11423 is for the scalp, neck, hands, feet, or genitalia rather than the trunk, arms, or legs.
Use 11603 for a malignant lesion at the same sites and size range; 11403 is for a benign lesion.
See how rates vary across the country
11403 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $234.44 | 1 |
| AL | $179.66 | 1 |
| AR | $177.13 | 1 |
| AZ | $194.46 | 1 |
| CA | $209.51–$260.61 | 29 |
| CO | $207.05 | 1 |
| CT | $212.82 | 1 |
| DC | $227.33 | 1 |
| DE | $197.61 | 1 |
| FL | $198.15–$217.90 | 3 |
| GA | $187.13–$203.70 | 2 |
| GU | $214.25 | 1 |
| HI | $214.25 | 1 |
| IA | $183.52 | 1 |
| ID | $184.81 | 1 |
| IL | $192.99–$211.63 | 4 |
| IN | $185.84 | 1 |
| KS | $182.96 | 1 |
| KY | $184.42 | 1 |
| LA | $184.25–$193.11 | 2 |
| MA | $205.97–$226.80 | 2 |
| MD | $201.23–$227.33 | 3 |
| ME | $186.05–$195.47 | 2 |
| MI | $189.37–$200.86 | 2 |
| MN | $197.68 | 1 |
| MO | $181.36–$193.44 | 3 |
| MS | $179.27 | 1 |
| MT | $199.72 | 1 |
| NC | $187.91 | 1 |
| ND | $194.78 | 1 |
| NE | $184.41 | 1 |
| NH | $204.09 | 1 |
| NJ | $215.05–$225.13 | 2 |
| NM | $190.49 | 1 |
| NV | $198.47 | 1 |
| NY | $190.68–$235.59 | 5 |
| OH | $188.36 | 1 |
| OK | $183.79 | 1 |
| OR | $196.73–$213.16 | 2 |
| PA | $188.49–$207.82 | 2 |
| PR | $201.06 | 1 |
| RI | $204.31 | 1 |
| SC | $188.48 | 1 |
| SD | $194.19 | 1 |
| TN | $183.90 | 1 |
| TX | $187.30–$206.54 | 8 |
| UT | $190.99 | 1 |
| VA | $195.05–$227.33 | 2 |
| VI | $201.06 | 1 |
| VT | $194.30 | 1 |
| WA | $205.49–$231.07 | 2 |
| WI | $188.43 | 1 |
| WV | $186.10 | 1 |
| WY | $197.57 | 1 |
Compare 11403 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $179.66 | Facility $123.55 |
| Alaska* | Office $234.44 | Facility $166.14 |
| Arizona | Office $194.46 | Facility $132.31 |
| Arkansas | Office $177.13 | Facility $122.04 |
| Atlanta | Office $203.70 | Facility $138.54 |
| Austin | Office $206.54 | Facility $138.69 |
| Bakersfield | Office $210.24 | Facility $139.96 |
| Baltimore/Surr. Cntys | Office $212.28 | Facility $143.47 |
| Beaumont | Office $187.30 | Facility $128.94 |
| Brazoria | Office $197.19 | Facility $133.64 |
| Chicago | Office $211.63 | Facility $147.18 |
| Chico | Office $209.51 | Facility $139.23 |
| Colorado | Office $207.05 | Facility $138.81 |
| Connecticut | Office $212.82 | Facility $143.75 |
| Dallas | Office $198.56 | Facility $134.69 |
| Dc + Md/Va Suburbs | Office $227.33 | Facility $151.79 |
| Delaware | Office $197.61 | Facility $134.25 |
| Detroit | Office $200.86 | Facility $138.97 |
| East St. Louis | Office $197.68 | Facility $138.68 |
| El Centro | Office $209.55 | Facility $139.27 |
| Fort Lauderdale | Office $208.20 | Facility $143.23 |
| Fort Worth | Office $197.36 | Facility $134.12 |
| Fresno | Office $209.51 | Facility $139.23 |
| Galveston | Office $197.86 | Facility $134.18 |
| Hanford-Corcoran | Office $209.51 | Facility $139.23 |
| Hawaii, Guam | Office $214.25 | Facility $141.34 |
| Houston | Office $202.43 | Facility $138.75 |
| Idaho | Office $184.81 | Facility $125.81 |
| Indiana | Office $185.84 | Facility $126.39 |
| Iowa | Office $183.52 | Facility $124.84 |
| Kansas | Office $182.96 | Facility $124.99 |
| Kentucky | Office $184.42 | Facility $127.41 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $223.47 | Facility $147.60 |
| Madera | Office $209.51 | Facility $139.23 |
| Manhattan | Office $229.78 | Facility $155.26 |
| Merced | Office $209.51 | Facility $139.23 |
| Metropolitan Boston | Office $226.80 | Facility $150.23 |
| Metropolitan Kansas City | Office $191.52 | Facility $131.30 |
| Metropolitan Philadelphia | Office $207.82 | Facility $141.06 |
| Metropolitan St. Louis | Office $193.44 | Facility $132.39 |
| Miami | Office $217.90 | Facility $151.14 |
| Minnesota | Office $197.68 | Facility $131.69 |
| Mississippi | Office $179.27 | Facility $124.05 |
| Modesto | Office $209.51 | Facility $139.23 |
| Montana** | Office $199.72 | Facility $135.59 |
| Napa | Office $241.24 | Facility $156.72 |
| Nebraska | Office $184.41 | Facility $125.22 |
| Nevada** | Office $198.47 | Facility $134.28 |
| New Hampshire | Office $204.09 | Facility $137.33 |
| New Mexico | Office $190.49 | Facility $131.69 |
| New Orleans | Office $193.11 | Facility $132.76 |
| North Carolina | Office $187.91 | Facility $128.07 |
| North Dakota** | Office $194.78 | Facility $130.65 |
| Northern Nj | Office $225.13 | Facility $150.74 |
| Nyc Suburbs/Long Island | Office $235.59 | Facility $159.34 |
| Ohio | Office $188.36 | Facility $129.80 |
| Oklahoma | Office $183.79 | Facility $126.53 |
| Oxnard-Thousand Oaks-Ventura | Office $222.21 | Facility $146.41 |
| Portland | Office $213.16 | Facility $141.92 |
| Poughkpsie/N Nyc Suburbs | Office $216.68 | Facility $146.46 |
| Puerto Rico | Office $201.06 | Facility $136.22 |
| Queens | Office $231.21 | Facility $155.40 |
| Redding | Office $209.51 | Facility $139.23 |
| Rest Of California | Office $209.51 | Facility $139.23 |
| Rest Of Florida | Office $198.15 | Facility $136.84 |
| Rest Of Georgia | Office $187.13 | Facility $129.92 |
| Rest Of Illinois | Office $192.99 | Facility $134.44 |
| Rest Of Louisiana | Office $184.25 | Facility $127.50 |
| Rest Of Maine | Office $186.05 | Facility $127.05 |
| Rest Of Maryland | Office $201.23 | Facility $136.33 |
| Rest Of Massachusetts | Office $205.97 | Facility $138.45 |
| Rest Of Michigan | Office $189.37 | Facility $130.81 |
| Rest Of Missouri | Office $181.36 | Facility $126.08 |
| Rest Of New Jersey | Office $215.05 | Facility $145.02 |
| Rest Of New York | Office $190.68 | Facility $129.75 |
| Rest Of Oregon | Office $196.73 | Facility $132.86 |
| Rest Of Pennsylvania | Office $188.49 | Facility $129.62 |
| Rest Of Texas | Office $192.22 | Facility $131.36 |
| Rest Of Washington | Office $205.49 | Facility $137.97 |
| Rhode Island | Office $204.31 | Facility $138.07 |
| Riverside-San Bernardino-Ontario | Office $212.22 | Facility $141.93 |
| Sacramento-Roseville-Folsom | Office $219.47 | Facility $144.88 |
| Salinas | Office $218.64 | Facility $144.31 |
| San Diego-Chula Vista-Carlsbad | Office $223.50 | Facility $146.80 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $254.86 | Facility $164.43 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $254.57 | Facility $164.15 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $260.61 | Facility $168.13 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $259.45 | Facility $166.97 |
| San Luis Obispo-Paso Robles | Office $215.17 | Facility $142.13 |
| Santa Cruz-Watsonville | Office $225.41 | Facility $147.49 |
| Santa Maria-Santa Barbara | Office $219.38 | Facility $144.61 |
| Santa Rosa-Petaluma | Office $227.66 | Facility $148.91 |
| Seattle (King Cnty) | Office $231.07 | Facility $152.38 |
| South Carolina | Office $188.48 | Facility $129.23 |
| South Dakota** | Office $194.19 | Facility $130.06 |
| Southern Maine | Office $195.47 | Facility $131.92 |
| Stockton | Office $209.51 | Facility $139.23 |
| Suburban Chicago | Office $210.16 | Facility $144.29 |
| Tennessee | Office $183.90 | Facility $125.60 |
| Utah | Office $190.99 | Facility $130.71 |
| Vallejo | Office $240.84 | Facility $156.31 |
| Vermont | Office $194.30 | Facility $130.81 |
| Virgin Islands | Office $201.06 | Facility $136.22 |
| Virginia | Office $195.05 | Facility $132.01 |
| Visalia | Office $209.51 | Facility $139.23 |
| West Virginia | Office $186.10 | Facility $130.37 |
| Wisconsin | Office $188.43 | Facility $127.00 |
| Wyoming** | Office $197.57 | Facility $133.44 |
| Yuba City | Office $209.51 | Facility $139.23 |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
