Billing code 11103: Tangential skin biopsyMedicare rate & RVUs in Washington
Report this add-on for each separate skin lesion sampled tangentially beyond the lesion represented by the primary biopsy code at the same session.
Medicare pays $50.47–$57.10 for 11103 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 11103 covers
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.
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 11103 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $50.47 | $17.76 |
| Seattle (King Cnty) | $57.10 | $18.99 |
How the 11103 rate is calculated
Each of 11103’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 · 11103
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.37Practice expense 1.05Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11103
The CMS indicators that decide how 11103 is paid alongside other services.
CMS payment indicators · 11103
Tangential skin biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
11103 compared with similar codes
Compare codes
11103 vs 11102 vs 11105 vs 11300 vs 11107: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 11102Tangential skin biopsy
- 11102 is the primary code for the first tangential biopsy; this add-on covers each further tangentially sampled lesion at the same session.
- 11105Skin biopsy
- 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.
- 11300Shave removal
- 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.
- 11107Skin biopsy
- 11107 applies when an additional lesion is sampled through an incision rather than by tangential sampling.
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 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
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