Billing code 11603: Lesion excisionMedicare rate & RVUs in Oregon
Excision of a malignant skin lesion on the trunk, arm, or leg, selected by the lesion’s diameter together with the margins removed.
Medicare pays $272.26–$294.12 for 11603 in the office in Oregon, from Rest Of Oregon to Portland. 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 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 in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $294.12 | $168.69 |
| Rest Of Oregon | $272.26 | $159.81 |
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.
How the rate is built · 11603
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.75Practice expense 5.19Malpractice 0.33
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11603
11603 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11603
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 · 11603
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
11603 without 51 · national office
$276.23
Lesion excision
11603-51 · Second procedure: 50%
$138.12
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%).
11603 compared with similar codes
Compare codes
11603 vs 11602 vs 11604 vs 11623 vs 11403: national Medicare rates
Swap in your local Medicare rate.
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.
11603 billing questions
How is the 2.1–3 cm size determined?
Use the greatest clinical diameter of the lesion plus the narrowest margins needed for excision, measured before removal. Do not select the size from the closure length.
When should a different site code be used?
This code is for the trunk, arms, and legs. Lesions on sites such as the face, ear, eyelid, nose, lip, hand, foot, or genitalia use their own anatomic code group.
Is closure separately reported?
Simple closure is included in the excision. A separately documented intermediate or complex repair may be reported when its requirements are met.
Can modifier 50 be used for lesions on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What postoperative care is included?
Related postoperative visits during the 10-day global period are included in the procedure.
How are multiple procedures in one session paid?
The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard multiple-procedure reduction.
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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