Billing code 11403: Benign lesion excisionMedicare rate & RVUs in Florida
Removal of a benign skin lesion on the trunk, arm, or leg when the lesion and margins measure 2.1 to 3 cm across.
Medicare pays $198.15–$217.90 for 11403 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 11403 covers
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.
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 11403 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$198.15 to $217.90
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $208.20 | $143.23 |
| Miami | $217.90 | $151.14 |
| Rest Of Florida | $198.15 | $136.84 |
How the 11403 rate is calculated
Each of 11403’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.
How the rate is built · 11403
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.79Practice expense 3.94Malpractice 0.25
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11403
11403 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11403
Benign lesion excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 11403
Benign lesion excision
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11403 without 51 · national office
$199.74
Benign lesion excision
11403-51 · Second procedure: 50%
$99.87
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
11403 compared with similar codes
Compare codes
11403 vs 11402 vs 11404 vs 11423 vs 11603: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 11402Skin lesion excision
- 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.
- 11404Skin excision
- This code covers 2.1 to 3 cm; 11404 applies to 3.1 to 4 cm at the same sites.
- 11423Skin excision
- The size range is the same, but 11423 is for the scalp, neck, hands, feet, or genitalia rather than the trunk, arms, or legs.
- 11603Lesion excision
- Use 11603 for a malignant lesion at the same sites and size range; 11403 is for a benign lesion.
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 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
Show the CMS file lines behind this rate
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