$184.33–$193.25
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.
On this page
CMS RVU26D · Effective 2026-10-01
11403 Benign lesion excision Medicare reimbursement rates in New Jersey
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 in New Jersey.
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 in New Jersey?
New Jersey has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$215.05–$225.13
2 of 2 localities have a supported rate.
Facility setting
$145.02–$150.74
2 of 2 localities have a supported rate.
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 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 rates for New Jersey, from the same CMS release.
$248.88–$260.34
This code covers 2.1 to 3 cm; 11404 applies to 3.1 to 4 cm at the same sites.
$224.52–$234.81
The size range is the same, but 11423 is for the scalp, neck, hands, feet, or genitalia rather than the trunk, arms, or legs.
$296.92–$310.50
Use 11603 for a malignant lesion at the same sites and size range; 11403 is for a benign lesion.
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.
2 of 2 payment localities
Northern Nj →
Office / nonfacility
$225.13
Facility
$150.74
Rest Of New Jersey →
Office / nonfacility
$215.05
Facility
$145.02
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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.
1,30911400,,Exc tr-ext b9+marg 0.5 cm<,A,,0.88,2.84,,1.30,,0.11,3.83,2.29,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31011401,,Exc tr-ext b9+marg 0.6-1 cm,A,,1.25,3.23,,1.42,,0.16,4.64,2.83,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31111402,,Exc tr-ext b9+marg 1.1-2 cm,A,,1.41,3.53,,1.48,,0.18,5.12,3.07,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31211403,,Exc tr-ext b9+marg 2.1-3cm,A,,1.79,3.94,,2.02,,0.25,5.98,4.06,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31311404,,Exc tr-ext b9+marg 3.1-4 cm,A,,2.06,4.50,,2.13,,0.36,6.92,4.55,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31411406,,Exc tr-ext b9+marg >4.0 cm,A,,3.43,5.92,,2.75,,0.64,9.99,6.82,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,31511420,,Exc h-f-nk-sp b9+marg 0.5/<,A,,1.00,2.63,,1.17,,0.11,3.74,2.28,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00