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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.

Find 11403 in your payment locality →

Where 11403 pays more and less

109 payment localities

$177.13 to $260.61

$177.13$218.87$260.61
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

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.

11402

Skin lesion excision

Trunk or extremity, 1.1–2 cm

$151.47–$225.52

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.

11404

Skin excision

Trunk or extremity, 3.1–4 cm

$204.11–$299.56

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

11423

Skin excision

Scalp, neck, hands, feet, or genitalia

$185.68–$270.57

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

11603

Lesion excision

Trunk or limb, 2.1–3 cm

$246.44–$357.84

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 / territoryRate 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

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

11403 office and facility rates by payment locality
Payment localityOfficeFacility
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.

RVUs for 11403PPRRVU2026_Oct_nonQPP.csv, line 1,312 (RVU26D)