How much does Medicare pay for CPT 11403?

Medicare allowed an average of $113.00 per service and paid $88.23 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $443.25, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11403?

Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm. It was billed 9,678 times to 8,775 Medicare beneficiaries by 431 providers in 2024.

Does 11403 pay differently in an office than a hospital?

Yes. The allowed amount averaged $114.81 in an office setting and $79.78 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 11403 most?

Dermatology, with 6,454 services from 280 clinicians. Next are Plastic and Reconstructive Surgery, Physician Assistant, Micrographic Dermatologic Surgery.

CPT 11403

Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm

$113.00Medicare-allowed amount per service, averaged across 9,678 services

Providers submitted

$443.25

Asking price, not received

Medicare allowed

$113.00

The fee schedule figure

Medicare paid

$88.23

Balance is patient coinsurance

Providers submitted an average of $443.25 for this code and Medicare allowed $113.00 — 3.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $88.23 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $114.81
Hospital / facility: $79.78

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 9,177 services were billed in an office setting and 501 in a facility.

Services: 9,678
Beneficiaries: 8,775
Providers billing it: 431
Total allowed: $1,093,614

What Medicare pays for CPT 11403

Across 9,678 services billed by 431 providers to 8,775 beneficiaries, Medicare allowed an average of $113.00 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 11403

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	6,454	5,841	$116.01	280
Plastic and Reconstructive Surgery	803	736	$96.53	36
Physician Assistant	701	634	$89.05	35
Micrographic Dermatologic Surgery	467	437	$102.92	26
General Surgery	266	245	$130.01	12
Ambulatory Surgical Center	236	217	$70.56	13
Internal Medicine	218	161	$180.42	4
Nurse Practitioner	197	186	$94.76	12
Family Practice	192	175	$111.06	9
Podiatry	107	106	$211.78	1
Otolaryngology	26	26	$99.82	2
Orthopedic Surgery	11	11	$92.17	1

11403 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	1,720	$128.69	$96.42	64
California	1,055	$118.25	$81.33	50
Texas	907	$121.20	$94.73	34
New York	608	$134.67	$91.60	25
New Jersey	477	$116.08	$84.75	15
Virginia	470	$104.02	$80.74	21
Pennsylvania	435	$98.94	$78.47	21
Illinois	409	$102.49	$75.07	20
South Carolina	293	$90.65	$74.67	14
Maryland	269	$112.43	$83.92	14
Indiana	260	$105.44	$86.80	10
Arizona	249	$111.43	$87.96	12
Ohio	235	$89.76	$74.40	13
Minnesota	220	$123.23	$89.67	6
Massachusetts	203	$111.31	$79.37	12
Nevada	181	$148.40	$118.13	5
Georgia	178	$79.18	$65.21	12
North Carolina	140	$96.15	$77.78	9
Tennessee	106	$82.16	$72.14	6
Washington	99	$106.38	$80.90	4
Oklahoma	94	$98.51	$80.14	4
Michigan	92	$95.96	$74.42	6
Mississippi	87	$91.07	$78.08	6
Missouri	82	$88.26	$74.25	6
Arkansas	80	$66.34	$58.57	4
Delaware	77	$86.97	$69.33	3
Wisconsin	73	$116.46	$91.17	4
Colorado	69	$104.29	$82.07	4
Kentucky	65	$87.61	$78.32	4
Louisiana	64	$124.32	$100.52	3
Alabama	62	$84.85	$75.04	3
New Hampshire	49	$100.78	$77.80	3
District of Columbia	49	$112.31	$77.85	1
West Virginia	46	$82.66	$75.56	3
North Dakota	32	$62.86	$47.30	1
Oregon	27	$96.94	$77.75	2
Hawaii	25	$111.51	$77.73	1
Nebraska	23	$94.35	$77.87	1
South Dakota	18	$95.38	$73.78	1
Maine	14	$102.74	$78.04	1
Guam	13	$106.00	$77.94	1
Kansas	12	$90.35	$77.93	1
Iowa	11	$68.13	$51.70	1

Related codes

11402Removal of noncancer skin growth of body$95.28
11401Removal of noncancer skin growth of body$104.57
11422Removal of noncancer skin growth of scalp$133.43
11442Removal of noncancer skin growth of face$128.75
11421Removal of noncancer skin growth of scalp$127.16
11440Removal of noncancer skin growth of face$102.78
11420Removal of noncancer skin growth of scalp$109.75
11441Removal of noncancer skin growth of face$118.75
11400Removal of noncancer skin growth of body$100.81
11404Removal of noncancer skin growth of body$151.01
11423Removal of noncancer skin growth of scalp$166.91
11406Removal of noncancer skin growth of body$212.80

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.