How much does Medicare pay for CPT 11603?

Medicare allowed an average of $145.33 per service and paid $114.49 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $610.35, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11603?

Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm. It was billed 92,236 times to 83,695 Medicare beneficiaries by 3,209 providers in 2024.

Does 11603 pay differently in an office than a hospital?

Yes. The allowed amount averaged $146.86 in an office setting and $119.81 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 11603 most?

Dermatology, with 69,044 services from 2,401 clinicians. Next are Physician Assistant, Micrographic Dermatologic Surgery, Plastic and Reconstructive Surgery.

CPT 11603

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

$145.33Medicare-allowed amount per service, averaged across 92,236 services

Providers submitted

$610.35

Asking price, not received

Medicare allowed

$145.33

The fee schedule figure

Medicare paid

$114.49

Balance is patient coinsurance

Providers submitted an average of $610.35 for this code and Medicare allowed $145.33 — 4.2× 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 $114.49 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $146.86
Hospital / facility: $119.81

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. 87,013 services were billed in an office setting and 5,223 in a facility.

Services: 92,236
Beneficiaries: 83,695
Providers billing it: 3,209
Total allowed: $13,404,658

What Medicare pays for CPT 11603

Across 92,236 services billed by 3,209 providers to 83,695 beneficiaries, Medicare allowed an average of $145.33 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 11603

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	69,044	62,645	$149.43	2,401
Physician Assistant	7,903	7,097	$122.92	292
Micrographic Dermatologic Surgery	5,228	4,897	$152.00	176
Plastic and Reconstructive Surgery	3,889	3,452	$138.95	128
Nurse Practitioner	1,734	1,586	$121.90	72
Ambulatory Surgical Center	1,468	1,312	$86.57	39
General Surgery	1,118	1,030	$155.00	40
Family Practice	635	562	$161.40	18
Surgical Oncology	339	317	$136.72	15
Otolaryngology	265	240	$150.45	8
Undefined Physician type	212	187	$123.44	3
Internal Medicine	178	160	$134.81	8
Pathology	83	82	$125.95	2
General Practice	43	40	$140.70	2
Orthopedic Surgery	26	24	$139.64	1

11603 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	15,375	$149.12	$115.05	451
California	9,253	$164.46	$115.06	331
Texas	5,597	$143.05	$113.04	214
Georgia	3,672	$138.61	$113.71	117
Pennsylvania	3,482	$145.75	$113.08	131
South Carolina	3,459	$132.98	$108.64	79
Virginia	3,429	$152.00	$119.54	110
North Carolina	3,375	$136.73	$112.01	110
Illinois	2,950	$144.04	$109.99	95
Arizona	2,891	$147.10	$116.41	115
Massachusetts	2,741	$149.60	$110.10	97
New York	2,719	$168.30	$114.89	99
Tennessee	2,514	$135.70	$116.48	93
Ohio	2,497	$137.76	$114.07	91
Maryland	2,191	$155.64	$113.88	78
New Jersey	1,826	$157.81	$111.53	60
Indiana	1,691	$125.32	$105.66	55
Missouri	1,521	$130.17	$109.45	60
Michigan	1,444	$139.10	$111.48	63
Alabama	1,390	$131.79	$115.09	47
Washington	1,389	$141.20	$107.44	54
Kentucky	1,234	$130.33	$112.61	39
Minnesota	1,092	$147.63	$113.84	42
Wisconsin	1,057	$145.20	$116.95	49
Iowa	981	$138.45	$114.42	31
Kansas	974	$126.69	$107.42	38
Arkansas	953	$125.09	$110.37	35
Mississippi	874	$128.48	$109.53	33
Colorado	834	$143.25	$109.00	40
Oklahoma	765	$133.79	$112.62	34
Connecticut	682	$150.52	$110.30	22
Oregon	653	$140.48	$111.84	34
West Virginia	589	$129.19	$107.91	17
Nevada	573	$144.01	$114.38	24
Nebraska	553	$129.09	$106.93	19
Delaware	517	$122.24	$96.22	15
New Hampshire	498	$148.78	$113.94	22
Louisiana	454	$136.07	$116.49	20
Wyoming	434	$109.63	$87.23	7
Hawaii	359	$176.24	$128.68	11
Rhode Island	349	$138.29	$106.14	15
Idaho	345	$129.21	$109.89	19
District of Columbia	323	$155.66	$109.41	7
Utah	291	$131.86	$110.45	16
Montana	261	$138.60	$108.69	11
North Dakota	251	$132.76	$106.23	11
South Dakota	250	$132.82	$107.81	11
New Mexico	223	$148.38	$115.38	13
Maine	157	$141.01	$113.55	9
Vermont	138	$131.17	$100.82	8
Alaska	122	$159.17	$108.73	5
Guam	24	$261.06	$208.42	1
ZZ	20	$138.85	$108.58	1

Related codes

11602Removal of cancer skin growth of body$124.23
11642Removal of cancer skin growth of face$146.34
11622Removal of cancer skin growth of scalp$140.18
11604Removal of cancer skin growth of body$207.87
11606Removal of cancer skin growth of body$351.85
11643Removal of cancer skin growth of face$186.77
11641Removal of cancer skin growth of face$146.08
11623Removal of cancer skin growth of scalp$165.51
11601Removal of cancer skin growth of body$150.65
11644Removal of cancer skin growth of face$292.35
11646Removal of cancer skin growth of face$427.86
11621Removal of cancer skin growth of scalp$153.64

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.