{
    "code": "11103",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/11103/2022/A",
    "release_specific_url": "https://localishealth.com/cpt/11103/2022/D",
    "description": "A sampling biopsy in which a blade removes a thin, shallow slice from a suspicious skin lesion for the pathology lab, covering each lesion beyond the first one sampled that day. The first such biopsy at a visit is reported with its own code, and this one accounts for the second, third, and so on. The technique takes only the surface layers, unlike a punch biopsy that removes a full-thickness cylinder of skin.",
    "answer": {
        "question": "How much did Medicare pay for CPT 11103 in Q4 2022?",
        "text": "Medicare paid $52.60 for CPT 11103 in the office (non-facility) setting and $22.15 in a facility under the Q4 2022 Physician Fee Schedule, effective October 2022. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2022, when it decreased 2.7%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2022,
        "quarter": "D",
        "label": "Q4 2022",
        "effective": "October 1 – December 31, 2022",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 52.6,
        "facility": 22.15,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.38,
        "practice_expense_non_facility": 1.1,
        "practice_expense_facility": 0.22,
        "malpractice": 0.04
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.6062,
    "source": {
        "label": "Physician relative value file (Q4 2022)",
        "cms_url": "https://www.cms.gov/files/zip/rvu22d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2022/D",
        "file": "PPRRVU22_OCT.csv",
        "row": 6074,
        "sha256": "f8774a019545e1fd71536837b20b74674c014b1acef3435d93456857885190ab"
    },
    "modified_at": "2026-08-04T03:12:03+00:00"
}