$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.
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CMS RVU26D · Effective 2026-10-01
11103 Tangential skin biopsy Medicare reimbursement rates in Delaware
Report this add-on for each separate skin lesion sampled tangentially beyond the lesion represented by the primary biopsy code at the same session. Compare 11103 office and facility rates across CMS payment localities in Delaware.
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 11103 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$48.27
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$17.58
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
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.
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.
$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.
$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.
$70.08
11107 applies when an additional lesion is sampled through an incision rather than by tangential sampling.
Compare 11103 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.
1 of 1 payment localities
Delaware →
Office / nonfacility
$48.27
Facility
$17.58
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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
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.37 | × 1.005 | 0.3718 |
| Practice expense | 1.05 | × 0.988 | 1.0374 |
| Malpractice | 0.04 | × 0.899 | 0.0360 |
| Total RVUs | 1.4452 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$48.27
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.37 | 1.005 |
| Practice expense | 1.05 | 0.988 |
| Malpractice | 0.04 | 0.899 |
(0.37 × 1.005 + 1.05 × 0.988 + 0.04 × 0.899) × $33.4009 = $48.27
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.37 | 1.005 |
| Practice expense | 0.12 | 0.988 |
| Malpractice | 0.04 | 0.899 |
(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.
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.
1,2681108T,,Strtctc icere impl 1+1traj,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,2691109T,,Strtctc icere impl 1+mlt trj,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,27011102,,Tangntl bx skin single les,A,,0.64,2.16,,0.20,,0.06,2.86,0.90,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,27111103,,Tangntl bx skin ea sep/addl,A,,0.37,1.05,,0.12,,0.04,1.46,0.53,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,27211104,,Punch bx skin single lesion,A,,0.81,2.73,,0.24,,0.09,3.63,1.14,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,27311105,,Punch bx skin ea sep/addl,A,,0.44,1.30,,0.13,,0.07,1.81,0.64,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,27411106,,Incal bx skn single les,A,,0.98,3.43,,0.29,,0.12,4.53,1.39,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503