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CMS RVU26D · Effective 2026-10-01

11103 in Delaware

Office / nonfacility

$48.27

Base rate per service

Facility setting

$17.58

Base rate per service

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.

Dermatology procedure

About 11103: Tangential skin biopsy, each additional lesion

Report this add-on for each separate skin lesion sampled tangentially beyond the lesion represented by the primary biopsy code at the same session.

This add-on captures a tangential sample from another distinct skin lesion during a session with a primary skin biopsy. A shave, scoop, saucerization, or curettage removes epidermis and sometimes dermis for diagnostic examination without a wedge incision. Dermatologists, primary care clinicians, nurse practitioners, and physician assistants perform these biopsies in offices or outpatient clinics when evaluating multiple suspicious lesions, such as possible basal cell carcinomas or atypical pigmented lesions. Routine hemostasis and simple closure are included.

Report one unit of 11103 for each additional lesion sampled tangentially, not for extra passes or fragments from the same lesion. For mixed methods, select the primary biopsy code by technique complexity: incisional before punch before tangential; select each add-on by its own technique. Document each lesion's location, clinical concern, sampling method, and corresponding specimen so the lesion count and technique are clear. CMS requires this add-on with a primary biopsy procedure and pays it within that procedure's global period.

CMS billing rules for 11103

Global period
Add-on code: billed only together with a primary procedure and paid within that procedure's global period.

Where the value comes from

  • Work RVU0.37 · 25%
  • Practice expense (office) RVU1.05 · 72%
  • Malpractice RVU0.04 · 3%

1.5M

Medicare services in 2024 · #107 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.

11103 compared with similar codes

Office rates for Delaware, from the same CMS release.

11102

Tangential skin biopsy

First or only lesion

$94.57

11102 is the primary code for the first tangential biopsy; this add-on covers each further tangentially sampled lesion at the same session.

11105

Skin biopsy

Each additional punch-biopsied lesion

$59.77

11105 applies when the additional lesion is sampled with a punch that yields a cylindrical core; 11103 applies to shave, scoop, saucerization, or curettage sampling.

11300

Shave removal

Trunk or extremity, 0.5 cm or less

$95.53

11300 describes shave removal of a lesion at an eligible body site, selected by lesion diameter. Use 11103 for a diagnostic tangential biopsy of an additional lesion.

11107

Skin biopsy

Each additional lesion

$70.08

11107 applies when an additional lesion is sampled through an incision rather than by tangential sampling.

The same code, a different location

How does Delaware compare?

11103 across payment areas

Same release and payment basis · bars start at $0

  1. Delaware · This locality

    $48.27

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $55.24

    $6.97 higher than Delaware

  3. Dc + Md/Va Suburbs

    $55.83

    $7.56 higher than Delaware

  4. Miami

    $52.25

    $3.98 higher than Delaware

  5. Chicago

    $50.76

    $2.49 higher than Delaware

  6. Manhattan

    $56.02

    $7.75 higher than Delaware

  7. Alaska*

    $56.62

    $8.35 higher than Delaware

Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 11103 ranges from $43.17 in Arkansas to $65.01 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Alabama

    Alabama · 11103

    Office

    $43.80

    Facility

    $16.62

    $4.47 lower than Delaware for the office setting.

  • Arkansas

    Arkansas · 11103

    Office

    $43.17

    Facility

    $16.49

    $5.10 lower than Delaware for the office setting.

  • Arizona

    Arizona · 11103

    Office

    $47.49

    Facility

    $17.39

    $0.78 lower than Delaware for the office setting.

  • Bakersfield

    California · 11103

    Office

    $51.84

    Facility

    $17.80

    $3.57 higher than Delaware for the office setting.

  • Chico

    California · 11103

    Office

    $51.72

    Facility

    $17.68

    $3.45 higher than Delaware for the office setting.

  • El Centro

    California · 11103

    Office

    $51.73

    Facility

    $17.68

    $3.46 higher than Delaware for the office setting.

  • Fresno

    California · 11103

    Office

    $51.72

    Facility

    $17.68

    $3.45 higher than Delaware for the office setting.

  • Hanford-Corcoran

    California · 11103

    Office

    $51.72

    Facility

    $17.68

    $3.45 higher than Delaware for the office setting.

  • Madera

    California · 11103

    Office

    $51.72

    Facility

    $17.68

    $3.45 higher than Delaware for the office setting.

  • Merced

    California · 11103

    Office

    $51.72

    Facility

    $17.68

    $3.45 higher than Delaware for the office setting.

  • Modesto

    California · 11103

    Office

    $51.72

    Facility

    $17.68

    $3.45 higher than Delaware for the office setting.

  • Napa

    California · 11103

    Office

    $60.04

    Facility

    $19.10

    $11.77 higher than Delaware for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 11103

    Office

    $54.99

    Facility

    $18.27

    $6.72 higher than Delaware for the office setting.

  • Redding

    California · 11103

    Office

    $51.72

    Facility

    $17.68

    $3.45 higher than Delaware for the office setting.

  • Rest Of California

    California · 11103

    Office

    $51.72

    Facility

    $17.68

    $3.45 higher than Delaware for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 11103

    Office

    $52.16

    Facility

    $18.11

    $3.89 higher than Delaware for the office setting.

  • Sacramento-Roseville-Folsom

    California · 11103

    Office

    $54.31

    Facility

    $18.18

    $6.04 higher than Delaware for the office setting.

  • Salinas

    California · 11103

    Office

    $54.10

    Facility

    $18.10

    $5.83 higher than Delaware for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 11103

    Office

    $55.40

    Facility

    $18.25

    $7.13 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 11103

    Office

    $63.60

    Facility

    $19.80

    $15.33 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 11103

    Office

    $63.55

    Facility

    $19.75

    $15.28 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 11103

    Office

    $65.01

    Facility

    $20.21

    $16.74 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 11103

    Office

    $64.82

    Facility

    $20.03

    $16.55 higher than Delaware for the office setting.

  • San Luis Obispo-Paso Robles

    California · 11103

    Office

    $53.23

    Facility

    $17.85

    $4.96 higher than Delaware for the office setting.

  • Santa Cruz-Watsonville

    California · 11103

    Office

    $55.95

    Facility

    $18.20

    $7.68 higher than Delaware for the office setting.

  • Santa Maria-Santa Barbara

    California · 11103

    Office

    $54.31

    Facility

    $18.09

    $6.04 higher than Delaware for the office setting.

  • Santa Rosa-Petaluma

    California · 11103

    Office

    $56.51

    Facility

    $18.37

    $8.24 higher than Delaware for the office setting.

  • Stockton

    California · 11103

    Office

    $51.72

    Facility

    $17.68

    $3.45 higher than Delaware for the office setting.

  • Vallejo

    California · 11103

    Office

    $59.97

    Facility

    $19.03

    $11.70 higher than Delaware for the office setting.

  • Visalia

    California · 11103

    Office

    $51.72

    Facility

    $17.68

    $3.45 higher than Delaware for the office setting.

  • Yuba City

    California · 11103

    Office

    $51.72

    Facility

    $17.68

    $3.45 higher than Delaware for the office setting.

  • Colorado

    Colorado · 11103

    Office

    $50.87

    Facility

    $17.81

    $2.60 higher than Delaware for the office setting.

  • Connecticut

    Connecticut · 11103

    Office

    $51.99

    Facility

    $18.54

    $3.72 higher than Delaware for the office setting.

  • Fort Lauderdale

    Florida · 11103

    Office

    $50.30

    Facility

    $18.83

    $2.03 higher than Delaware for the office setting.

  • Rest Of Florida

    Florida · 11103

    Office

    $47.89

    Facility

    $18.20

    $0.38 lower than Delaware for the office setting.

  • Atlanta

    Georgia · 11103

    Office

    $49.63

    Facility

    $18.07

    $1.36 higher than Delaware for the office setting.

  • Rest Of Georgia

    Georgia · 11103

    Office

    $45.23

    Facility

    $17.53

    $3.04 lower than Delaware for the office setting.

  • Hawaii, Guam

    Hawaii · 11103

    Office

    $53.01

    Facility

    $17.69

    $4.74 higher than Delaware for the office setting.

  • Iowa

    Iowa · 11103

    Office

    $44.98

    Facility

    $16.56

    $3.29 lower than Delaware for the office setting.

  • Idaho

    Idaho · 11103

    Office

    $45.26

    Facility

    $16.68

    $3.01 lower than Delaware for the office setting.

  • East St. Louis

    Illinois · 11103

    Office

    $47.31

    Facility

    $18.74

    $0.96 lower than Delaware for the office setting.

  • Rest Of Illinois

    Illinois · 11103

    Office

    $46.47

    Facility

    $18.11

    $1.80 lower than Delaware for the office setting.

  • Suburban Chicago

    Illinois · 11103

    Office

    $50.83

    Facility

    $18.93

    $2.56 higher than Delaware for the office setting.

  • Indiana

    Indiana · 11103

    Office

    $45.52

    Facility

    $16.72

    $2.75 lower than Delaware for the office setting.

  • Kansas

    Kansas · 11103

    Office

    $44.74

    Facility

    $16.66

    $3.53 lower than Delaware for the office setting.

  • Kentucky

    Kentucky · 11103

    Office

    $44.76

    Facility

    $17.14

    $3.51 lower than Delaware for the office setting.

  • New Orleans

    Louisiana · 11103

    Office

    $46.88

    Facility

    $17.65

    $1.39 lower than Delaware for the office setting.

  • Rest Of Louisiana

    Louisiana · 11103

    Office

    $44.68

    Facility

    $17.19

    $3.59 lower than Delaware for the office setting.

  • Metropolitan Boston

    Massachusetts · 11103

    Office

    $55.93

    Facility

    $18.84

    $7.66 higher than Delaware for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 11103

    Office

    $50.55

    Facility

    $17.84

    $2.28 higher than Delaware for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 11103

    Office

    $51.84

    Facility

    $18.51

    $3.57 higher than Delaware for the office setting.

  • Rest Of Maryland

    Maryland · 11103

    Office

    $49.20

    Facility

    $17.76

    $0.93 higher than Delaware for the office setting.

  • Rest Of Maine

    Maine · 11103

    Office

    $45.45

    Facility

    $16.88

    $2.82 lower than Delaware for the office setting.

  • Southern Maine

    Maine · 11103

    Office

    $47.96

    Facility

    $17.17

    $0.31 lower than Delaware for the office setting.

  • Detroit

    Michigan · 11103

    Office

    $48.45

    Facility

    $18.48

    $0.18 higher than Delaware for the office setting.

  • Rest Of Michigan

    Michigan · 11103

    Office

    $45.89

    Facility

    $17.53

    $2.38 lower than Delaware for the office setting.

  • Minnesota

    Minnesota · 11103

    Office

    $48.84

    Facility

    $16.88

    $0.57 higher than Delaware for the office setting.

  • Metropolitan Kansas City

    Missouri · 11103

    Office

    $46.60

    Facility

    $17.43

    $1.67 lower than Delaware for the office setting.

  • Metropolitan St. Louis

    Missouri · 11103

    Office

    $47.08

    Facility

    $17.51

    $1.19 lower than Delaware for the office setting.

  • Rest Of Missouri

    Missouri · 11103

    Office

    $43.89

    Facility

    $17.11

    $4.38 lower than Delaware for the office setting.

  • Mississippi

    Mississippi · 11103

    Office

    $43.54

    Facility

    $16.80

    $4.73 lower than Delaware for the office setting.

  • Montana**

    Montana · 11103

    Office

    $48.76

    Facility

    $17.70

    $0.49 higher than Delaware for the office setting.

  • North Carolina

    North Carolina · 11103

    Office

    $45.93

    Facility

    $16.95

    $2.34 lower than Delaware for the office setting.

  • North Dakota**

    North Dakota · 11103

    Office

    $47.97

    Facility

    $16.91

    $0.30 lower than Delaware for the office setting.

  • Nebraska

    Nebraska · 11103

    Office

    $45.23

    Facility

    $16.56

    $3.04 lower than Delaware for the office setting.

  • New Hampshire

    New Hampshire · 11103

    Office

    $50.04

    Facility

    $17.70

    $1.77 higher than Delaware for the office setting.

  • Northern Nj

    New Jersey · 11103

    Office

    $55.25

    Facility

    $19.21

    $6.98 higher than Delaware for the office setting.

  • Rest Of New Jersey

    New Jersey · 11103

    Office

    $52.62

    Facility

    $18.70

    $4.35 higher than Delaware for the office setting.

  • New Mexico

    New Mexico · 11103

    Office

    $46.12

    Facility

    $17.64

    $2.15 lower than Delaware for the office setting.

  • Nevada**

    Nevada · 11103

    Office

    $48.58

    Facility

    $17.48

    $0.31 higher than Delaware for the office setting.

  • Nyc Suburbs/Long Island

    New York · 11103

    Office

    $57.33

    Facility

    $20.40

    $9.06 higher than Delaware for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 11103

    Office

    $52.93

    Facility

    $18.92

    $4.66 higher than Delaware for the office setting.

  • Queens

    New York · 11103

    Office

    $56.53

    Facility

    $19.81

    $8.26 higher than Delaware for the office setting.

  • Rest Of New York

    New York · 11103

    Office

    $46.61

    Facility

    $17.11

    $1.66 lower than Delaware for the office setting.

  • Ohio

    Ohio · 11103

    Office

    $45.72

    Facility

    $17.36

    $2.55 lower than Delaware for the office setting.

  • Oklahoma

    Oklahoma · 11103

    Office

    $44.71

    Facility

    $16.98

    $3.56 lower than Delaware for the office setting.

  • Portland

    Oregon · 11103

    Office

    $52.51

    Facility

    $18.00

    $4.24 higher than Delaware for the office setting.

  • Rest Of Oregon

    Oregon · 11103

    Office

    $48.23

    Facility

    $17.29

    $0.04 lower than Delaware for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 11103

    Office

    $50.68

    Facility

    $18.35

    $2.41 higher than Delaware for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 11103

    Office

    $45.82

    Facility

    $17.30

    $2.45 lower than Delaware for the office setting.

  • Puerto Rico

    Puerto Rico · 11103

    Office

    $49.13

    Facility

    $17.73

    $0.86 higher than Delaware for the office setting.

  • Rhode Island

    Rhode Island · 11103

    Office

    $50.01

    Facility

    $17.93

    $1.74 higher than Delaware for the office setting.

  • South Carolina

    South Carolina · 11103

    Office

    $45.90

    Facility

    $17.20

    $2.37 lower than Delaware for the office setting.

  • South Dakota**

    South Dakota · 11103

    Office

    $47.88

    Facility

    $16.82

    $0.39 lower than Delaware for the office setting.

  • Tennessee

    Tennessee · 11103

    Office

    $44.96

    Facility

    $16.72

    $3.31 lower than Delaware for the office setting.

  • Austin

    Texas · 11103

    Office

    $50.67

    Facility

    $17.81

    $2.40 higher than Delaware for the office setting.

  • Beaumont

    Texas · 11103

    Office

    $45.51

    Facility

    $17.25

    $2.76 lower than Delaware for the office setting.

  • Brazoria

    Texas · 11103

    Office

    $48.25

    Facility

    $17.47

    $0.02 lower than Delaware for the office setting.

  • Dallas

    Texas · 11103

    Office

    $48.55

    Facility

    $17.61

    $0.28 higher than Delaware for the office setting.

  • Fort Worth

    Texas · 11103

    Office

    $48.21

    Facility

    $17.59

    $0.06 lower than Delaware for the office setting.

  • Galveston

    Texas · 11103

    Office

    $48.39

    Facility

    $17.54

    $0.12 higher than Delaware for the office setting.

  • Houston

    Texas · 11103

    Office

    $49.12

    Facility

    $18.28

    $0.85 higher than Delaware for the office setting.

  • Rest Of Texas

    Texas · 11103

    Office

    $46.85

    Facility

    $17.37

    $1.42 lower than Delaware for the office setting.

  • Utah

    Utah · 11103

    Office

    $46.52

    Facility

    $17.33

    $1.75 lower than Delaware for the office setting.

  • Virginia

    Virginia · 11103

    Office

    $47.78

    Facility

    $17.24

    $0.49 lower than Delaware for the office setting.

  • Virgin Islands

    United States Virgin Islands · 11103

    Office

    $49.13

    Facility

    $17.73

    $0.86 higher than Delaware for the office setting.

  • Vermont

    Vermont · 11103

    Office

    $47.75

    Facility

    $17.00

    $0.52 lower than Delaware for the office setting.

  • Rest Of Washington

    Washington · 11103

    Office

    $50.47

    Facility

    $17.76

    $2.20 higher than Delaware for the office setting.

  • Seattle (King Cnty)

    Washington · 11103

    Office

    $57.10

    Facility

    $18.99

    $8.83 higher than Delaware for the office setting.

  • Wisconsin

    Wisconsin · 11103

    Office

    $46.37

    Facility

    $16.61

    $1.90 lower than Delaware for the office setting.

  • West Virginia

    West Virginia · 11103

    Office

    $44.75

    Facility

    $17.75

    $3.52 lower than Delaware for the office setting.

  • Wyoming**

    Wyoming · 11103

    Office

    $48.42

    Facility

    $17.36

    $0.15 higher than Delaware for the office setting.

See how rates vary across the country

11103 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$43.17

$58.37

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$56.621
AL$43.801
AR$43.171
AZ$47.491
CA$51.72–$65.0129
CO$50.871
CT$51.991
DC$55.831
DE$48.271
FL$47.89–$52.253
GA$45.23–$49.632
GU$53.011
HI$53.011
IA$44.981
ID$45.261
IL$46.47–$50.834
IN$45.521
KS$44.741
KY$44.761
LA$44.68–$46.882
MA$50.55–$55.932
MD$49.20–$55.833
ME$45.45–$47.962
MI$45.89–$48.452
MN$48.841
MO$43.89–$47.083
MS$43.541
MT$48.761
NC$45.931
ND$47.971
NE$45.231
NH$50.041
NJ$52.62–$55.252
NM$46.121
NV$48.581
NY$46.61–$57.335
OH$45.721
OK$44.711
OR$48.23–$52.512
PA$45.82–$50.682
PR$49.131
RI$50.011
SC$45.901
SD$47.881
TN$44.961
TX$45.51–$50.678
UT$46.521
VA$47.78–$55.832
VI$49.131
VT$47.751
WA$50.47–$57.102
WI$46.371
WV$44.751
WY$48.421

Explore 11103 on the national rate map →

Where does this rate apply?

Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Delaware →

Why are the office and facility amounts different?

For 11103 in Delaware, the physician’s office rate is $48.27 and the facility-setting rate is $17.58: a difference of $30.69.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 11103 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$53.10

$48.27 × 110% = $53.10

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 11103 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

1,271

Code
11103
Physician work
0.37
Practice expense
1.05
Malpractice
0.04

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office / nonfacility calculation for 11103 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.37× 1.0050.3718
Practice expense1.05× 0.9881.0374
Malpractice0.04× 0.8990.0360
Total RVUs1.4452
Conversion factor× 33.4009

Office / nonfacility rate, Delaware$48.27

Open 11103 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.371.005
Practice expense1.050.988
Malpractice0.040.899

(0.37 × 1.005 + 1.05 × 0.988 + 0.04 × 0.899) × $33.4009 = $48.27

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.371.005
Practice expense0.120.988
Malpractice0.040.899

(0.37 × 1.005 + 0.12 × 0.988 + 0.04 × 0.899) × $33.4009 = $17.58

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

11103 · Office / nonfacility

$48.27

Effective 2026-10-01

The base rate is $0.63 higher than on 2025-10-01, moving from $47.64 to $48.27 (1.3%).

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

    $47.64changed to$48.27

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.38 changed to 0.37
    • Practice expense RVU 1.06 changed to 1.05
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $47.64

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$48.27$17.58RVU26D
2026-07-01$48.27$17.58RVU26C
2026-04-01$48.27$17.58RVU26B
2026-01-01$48.27$17.58RVU26A
2025-10-01$47.64$21.01RVU25D
2025-07-01$47.64$21.01RVU25C
2025-04-01$47.64$21.01RVU25B
2025-01-01$47.64$21.01RVU25A

11103 billing questions

Which primary codes can this add-on be reported with?

It can be reported with 11102 for a first tangential biopsy, or with 11104 or 11106 when the primary lesion was sampled by punch or incisional technique. The primary code reflects the most intensive biopsy method performed that session.

If one lesion is punch biopsied and two are shaved, how is it coded?

Report 11104 for the punch biopsy and two units of 11103 for the two tangential biopsies. The tangential primary code 11102 is not used because a more intensive method was performed.

How is a shave biopsy distinguished from a shave removal?

A tangential biopsy samples a lesion for diagnosis; shave removal codes 11300-11313 describe removal of a lesion and are selected by site and diameter. Use the documented purpose and extent of the procedure, not specimen submission alone, to distinguish them.

Can multiple samples from the same lesion be counted as additional units?

No. Units count separate lesions, not multiple fragments or passes on one lesion. Each additional unit needs a distinct lesion with its own documented site.

Can an E/M visit be billed on the same day?

Yes, when a significant, separately identifiable evaluation beyond the usual pre-biopsy assessment is documented, using modifier 25 on the E/M code. The decision to biopsy alone does not support a separate visit.

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 11103PPRRVU2026_Oct_nonQPP.csv, line 1,271 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet