Billing code 11603: Lesion excisionMedicare rate & RVUs

Medicare pays $276.23 for 11603 nationally in the office and $163.33 in a hospital or facility. Local office rates run $246.44–$357.84.

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

What 11603 covers

This service removes a malignant skin lesion from the trunk, an arm, or a leg, including the surrounding margins taken for complete excision. Dermatologists, surgeons, and other qualified practitioners commonly perform it in an office procedure room or an outpatient facility. The removed tissue is typically submitted for pathology. The code applies to an excised diameter of 2.1–3 cm; face, ear, eyelid, nose, lip, hand, foot, and genital sites belong to different anatomic code groups.

Select the size level using the lesion’s greatest clinical diameter plus the narrowest margins needed for excision, measured before removal. Document the site, lesion and margin measurements, malignant diagnosis or clinical basis for excision, and procedure performed. Simple closure is included; a separately documented intermediate or complex repair may be reportable. The 10-day global period includes related postoperative visits during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 11603 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

11603 rates by state

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

How the 11603 rate is calculated

Each of 11603’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 11603

11603 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

11603 compared with similar codes

How to choose

11602Malignant lesion excision

Use 11602 for the same trunk-or-limb site group when the excised diameter is 1.1–2 cm; use 11603 for 2.1–3 cm.

11604Malignant excision

Use 11604 for the same trunk-or-limb site group when the excised diameter is 3.1–4 cm, rather than 2.1–3 cm.

11623Skin excision

The size level matches, but 11623 is for a different anatomic site group. Choose by the lesion’s location, not size alone.

11403Benign lesion excision

This is the comparable trunk-or-limb size level for a benign lesion. Use the malignant-lesion code when the diagnosis and circumstances support malignant excision.

Codes related to 11603

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