How can I find out the estimated cost of a specific medical procedure or service in my area?

To find the estimated cost of a specific medical procedure or service, such as one identified by a CPT code, based on your location and potentially your insurance, you can utilize specialized tools. It's recommended to use platforms like Payerprice, which offers a fee schedule lookup tool. You can search with the CPT code and your specific location to get detailed cost estimates. This will help you understand potential out-of-pocket expenses and compare costs across providers.

What if I have other specific questions about medical billing, insurance coverage, or healthcare costs that are not covered here?

If you have further specific questions related to medical billing, insurance coverage, or healthcare costs, especially concerning price transparency for particular procedures, it's best to consult resources that provide detailed, location-specific data. For fee schedules and procedure cost lookups using CPT codes and your specific location, you can utilize tools like Payerprice. For general insurance questions, contact your insurance provider directly. For questions about your medical bill, contact your healthcare provider's billing department.

Why are medical costs so different between different providers or locations?

Medical costs can vary significantly due to a multitude of factors, including the type of facility (e.g., hospital vs. outpatient clinic), the geographic location, the specific health plan's negotiated rates, the provider's experience and reputation, the complexity of the service, and variations in administrative overhead. These differences highlight the importance of price transparency. To research specific procedure costs based on CPT codes and location, tools like Payerprice can be very helpful in comparing prices across different providers and understanding the market rates in your area.

CPT 11403 Fee Schedule

Q: What factors affect fee schedules?

Fee schedules are affected by Medicare & Medicaid Rates (Government-set reimbursement amounts), Private Insurance Rates (Negotiated rates between providers and insurance companies), Geographic Location (Costs may be higher in urban areas), and Provider Type (Hospital providers may have different rates than private practice).

Last Verified: October 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Exc Tr Ext B9 Marg 2 1 3cm, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Trunk Arms Or Legs Excised Diameter 2 1 To 3 0 Cm

Key Fact	Detail
Service Type	Surgery Surgical Procedures on the Integumentary System
Common Place of Service	11 - Office 22 - On Campus Outpatient Hospital
Common Modifiers	None 59 - Distinct Procedural Service 51 - Multiple procedures
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 11403
Medicaid Fee Schedule	View Medicaid rates for 11403

National average reimbursement for CPT 11403 by major payers:

$210.11

$242.67

$255.40

$243.96

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Choose a payer to see a sample of rates for CPT 11403.

CPT 11403

5 of 25 sample ratesHigher to lower in this preview

Timothy Iafe
Regents Of The University Of California
CADiagnostic Radiology PhysicianNPI 1508251422Tax ID 61-1729294
$894.61Published rate
Stuart Braverman
Sansum Clinic
CADiagnostic Radiology PhysicianNPI 1811940901Tax ID 95-6419205
$453.62Published rate
David Gallegos
St Vincent Hospital
TNOtolaryngology PhysicianNPI 1710113345Tax ID 85-0106941
$305.28Published rate
Brandon Frye
Blackstone Hand Center LLC
FLOrthopaedic Hand Surgery PhysicianNPI 1669621785Tax ID 47-1980839
$225.35Published rate
Mershad Hagigi
Dr. Luis F. Luna, Md LLC
NYDiagnostic Radiology PhysicianNPI 1700083763Tax ID 27-0352762
$125.45Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 11403 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 11403 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 11403 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
11400-CPT	Low	Exc Tr Ext B9 Marg 0 5 Cm, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Trunk Arms Or Legs Excised Diameter 0 5 Cm Or Less
11401-CPT	Low	Exc Tr Ext B9 Marg 0 6 1 Cm, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Trunk Arms Or Legs Excised Diameter 0 6 To 1 0 Cm
11402-CPT	Low	Exc Tr Ext B9 Marg 1 1 2 Cm, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Trunk Arms Or Legs Excised Diameter 1 1 To 2 0 Cm
11403-CPT	Moderate	Exc Tr Ext B9 Marg 2 1 3cm, Excision Benign Lesion Including Margins Except Skin Tag Unless Listed Elsewhere Trunk Arms Or Legs Excised Diameter 2 1 To 3 0 Cm

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11403. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 11403 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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CPT 11403 Fee Schedule

Timothy Iafe

Stuart Braverman

David Gallegos

Brandon Frye

Mershad Hagigi