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CPT 11103: Additional Tangential (Shave/Curette) Skin Lesion Biopsy

CPT code 11103 represents an additional tangential skin biopsy (shave or curette) performed for each separate lesion sampled beyond the single‑lesion code 11102. This code is used across outpatient dermatology and office‑based settings where clinicians perform shave or scoop biopsies to diagnose benign and malignant skin lesions. Nationally, accurate reporting of 11103 supports clinical documentation, encounter coding completeness, and payer adjudication for multiple lesion sampling.

Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an explanation of the clinical procedure and typical sites of service, comparisons to the single‑lesion companion code 11102, and an outline of common billing contexts where 11103 is appended for additional lesions. The publication also summarizes common coding and coverage considerations that affect claim processing, and presents benchmarking and policy updates relevant to tangential biopsy coding practices.

This overview is intended for coders, dermatology clinicians, and revenue cycle professionals who need a concise reference to the purpose and application of 11103, the relationship to the primary lesion code, and payer coverage landscape at a national level.

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Billing Code Overview

CPT code 11103 describes an additional tangential (shave or curette) biopsy of a skin lesion, reported when one or more extra lesions are sampled in addition to the primary tangential biopsy reported with 11102. The technique uses a tangential, side‑ways approach to shave off or scoop out the lesion with a knife or curette.

Service Type: Skin biopsy — tangential (shave/scoop/curette)

Typical Site of Service: Outpatient dermatology clinic, physician office, or ambulatory surgical setting

National Reimbursement Benchmarks

National averages place Medicare at a mean of $50.6 and BUCA (average commercial) notably higher at $118.2, indicating commercial contracts represented by BUCA pay on average about $67.6 more than Medicare for CPT 11103. This gap highlights a substantial commercial-to-Medicare premium for this procedure.

Examining dispersion (P75 minus P25) highlights variability across carriers: Blue Cross Blue Shield has a range of $74.6 (P75 $195.9 minus P25 $121.3), UnitedHealth Group shows a range of $58.9, and BUCA’s interquartile spread is $58.2. Aetna and Cigna are tighter, with ranges of $55.9 and $44.5 respectively. Medicare’s interquartile spread is narrow at $6 (P75 $53 minus P25 $47), reflecting the most compressed distribution among payers.

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CPT 11103: Additional Tangential (Shave/Curette) Skin Lesion Biopsy

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Billing Code Overview

Service Type: Skin biopsy — tangential (shave/scoop/curette)

Typical Site of Service: Outpatient dermatology clinic, physician office, or ambulatory surgical setting

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

A 52-year-old patient presents to a dermatology clinic with multiple raised, pigmented papules on the dorsal surface of the right forearm. The clinician identifies one lesion as the primary target for diagnostic tangential biopsy and performs a shave biopsy reported as 11102. During the same encounter, two additional clinically suspicious benign-appearing lesions on the same arm are sampled using tangential (shave/scoop) technique. Each additional lesion is reported with +11103 in addition to the primary 11102 code. The typical workflow includes lesion inspection, informed consent, local anesthesia (e.g., lidocaine), hemostasis (electrocautery or chemical), specimen labeling and submission to pathology, and brief postoperative instructions. Documentation includes lesion location, size, indication, technique (tangential/shave/curette), number of specimens, and specimen disposition. Typical site of service is an outpatient dermatology clinic, physician office, or ambulatory surgical center where minor skin procedures are performed.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure	Use when an E/M visit is performed and documented as distinct from the biopsy service
`59`	Distinct procedural service	Use to indicate a separate lesion or procedure that is distinct from another service, where applicable (use with caution and per payer guidance)
`76`	Repeat procedure or service by same physician	Use when the same tangential biopsy is repeated by the same provider later the same day
`77`	Repeat procedure by another physician	Use when another physician repeats the tangential biopsy the same day
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned
`53`	Discontinued procedure	Use when the biopsy was started but discontinued due to patient condition or unforeseen complication
`59`	Distinct procedural service	Use when the additional lesion is anatomically or clinically distinct from the primary lesion (follow payer guidance)
`26`	Professional component	Rarely used for tangential biopsies; use if billing only the professional component separate from a facility
`RT`	Right side	Use to indicate the procedure was performed on the right side when side-specific reporting is required
`LT`	Left side	Use to indicate the procedure was performed on the left side when side-specific reporting is required
`50`	Bilateral procedure	Not typically applicable to `11102`/`11103`; use only if payer accepts bilateral modifier for paired lesions
`59`	Distinct procedural service	Note: CMS encourages use of more specific modifiers (e.g., `XS`, `XU`) when available
`XS`	Separate structure, same surgical session	Use when additional lesion represents a separate lesion/site during the same session
`XU`	Unusual non-overlapping service	Use when the additional lesion biopsy is for an unrelated condition at a different site

Taxonomy Code	Specialty	Notes
`207N00000X`	Dermatology Physician	Primary specialty performing cutaneous tangential biopsies
`207ND0101X`	MOHS-Micrographic Surgery Physician	Performs skin lesion excisions and specialized biopsies; may perform tangential biopsies pre-MOHS
`207Q00000X`	Family Medicine Physician	May perform office-based shave/tangential biopsies in primary care settings

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D23.111`	Other benign neoplasm of skin of right arm, forearm and hand	Common benign lesion location prompting tangential biopsy when clinical diagnosis is uncertain
`D23.112`	Other benign neoplasm of skin of left arm, forearm and hand	Same clinical relevance for left-sided lesions
`D23.121`	Other benign neoplasm of skin of right lower limb, including hip	Tangential biopsies may be performed on benign-appearing lesions of the lower limb
`D23.122`	Other benign neoplasm of skin of left lower limb, including hip	Applies to left lower extremity benign lesions where shave biopsy is clinically indicated

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11102`	Tangential biopsy of skin (e.g., shave, scoop, saucerize, curette); single lesion	Primary code for a single tangential biopsy; `11103` is reported for each additional lesion sampled in the same session

CPT 11102: Tangential (Shave) Biopsy of Single Skin Lesion

CPT-11104-PUNCH-BIOPSY-SKIN-LESION

CPT 11104: Punch Biopsy of Skin Lesion, Full-Thickness Circular Sample

CPT-11105-ADDITIONAL-PUNCH-BIOPSY-SKIN-LESION

CPT 11105: Additional Punch Biopsy of Skin Lesion

CPT-11106-INCISIONAL-WEDGE-SKIN-BIOPSY

CPT 11106: Incisional or Wedge Biopsy of Skin Lesion

CPT-11107-ADDITIONAL-SKIN-LESION-INCISIONAL-WEDGE-BIOPSY

CPT 11107: Additional Incisional/Wedge Skin Lesion Biopsy

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure	Use when an E/M visit is performed and documented as distinct from the biopsy service
`59`	Distinct procedural service	Use to indicate a separate lesion or procedure that is distinct from another service, where applicable (use with caution and per payer guidance)
`76`	Repeat procedure or service by same physician	Use when the same tangential biopsy is repeated by the same provider later the same day
`77`	Repeat procedure by another physician	Use when another physician repeats the tangential biopsy the same day
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned
`53`	Discontinued procedure	Use when the biopsy was started but discontinued due to patient condition or unforeseen complication
`59`	Distinct procedural service	Use when the additional lesion is anatomically or clinically distinct from the primary lesion (follow payer guidance)
`26`	Professional component	Rarely used for tangential biopsies; use if billing only the professional component separate from a facility
`RT`	Right side	Use to indicate the procedure was performed on the right side when side-specific reporting is required
`LT`	Left side	Use to indicate the procedure was performed on the left side when side-specific reporting is required
`50`	Bilateral procedure	Not typically applicable to `11102`/`11103`; use only if payer accepts bilateral modifier for paired lesions
`59`	Distinct procedural service	Note: CMS encourages use of more specific modifiers (e.g., `XS`, `XU`) when available
`XS`	Separate structure, same surgical session	Use when additional lesion represents a separate lesion/site during the same session
`XU`	Unusual non-overlapping service	Use when the additional lesion biopsy is for an unrelated condition at a different site

Taxonomy Code	Specialty	Notes
`207N00000X`	Dermatology Physician	Primary specialty performing cutaneous tangential biopsies
`207ND0101X`	MOHS-Micrographic Surgery Physician	Performs skin lesion excisions and specialized biopsies; may perform tangential biopsies pre-MOHS
`207Q00000X`	Family Medicine Physician	May perform office-based shave/tangential biopsies in primary care settings

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D23.111`	Other benign neoplasm of skin of right arm, forearm and hand	Common benign lesion location prompting tangential biopsy when clinical diagnosis is uncertain
`D23.112`	Other benign neoplasm of skin of left arm, forearm and hand	Same clinical relevance for left-sided lesions
`D23.121`	Other benign neoplasm of skin of right lower limb, including hip	Tangential biopsies may be performed on benign-appearing lesions of the lower limb
`D23.122`	Other benign neoplasm of skin of left lower limb, including hip	Applies to left lower extremity benign lesions where shave biopsy is clinically indicated

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11102`	Tangential biopsy of skin (e.g., shave, scoop, saucerize, curette); single lesion	Primary code for a single tangential biopsy; `11103` is reported for each additional lesion sampled in the same session

CPT 11102: Tangential (Shave) Biopsy of Single Skin Lesion

CPT-11104-PUNCH-BIOPSY-SKIN-LESION

CPT 11104: Punch Biopsy of Skin Lesion, Full-Thickness Circular Sample

CPT-11105-ADDITIONAL-PUNCH-BIOPSY-SKIN-LESION

CPT 11105: Additional Punch Biopsy of Skin Lesion

CPT-11106-INCISIONAL-WEDGE-SKIN-BIOPSY

CPT 11106: Incisional or Wedge Biopsy of Skin Lesion

CPT-11107-ADDITIONAL-SKIN-LESION-INCISIONAL-WEDGE-BIOPSY

CPT 11107: Additional Incisional/Wedge Skin Lesion Biopsy

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 11103: Additional Tangential (Shave/Curette) Skin Lesion Biopsy

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Billing Code Overview

National Reimbursement Benchmarks

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CPT 11103: Additional Tangential (Shave/Curette) Skin Lesion Biopsy

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Billing Code Overview

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References