How much does Medicare pay for CPT 11045?

Medicare allowed an average of $28.86 per service and paid $22.87 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $95.69, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11045?

Removal of skin and tissue, each additional 20.0 sq cm or less. It was billed 420,819 times to 49,222 Medicare beneficiaries by 2,115 providers in 2024.

Does 11045 pay differently in an office than a hospital?

Yes. The allowed amount averaged $34.65 in an office setting and $23.11 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 11045 most?

Nurse Practitioner, with 159,385 services from 913 clinicians. Next are General Surgery, Physician Assistant, Podiatry.

CPT 11045

Removal of skin and tissue, each additional 20.0 sq cm or less

$28.86Medicare-allowed amount per service, averaged across 420,819 services

Providers submitted

$95.69

Asking price, not received

Medicare allowed

$28.86

The fee schedule figure

Medicare paid

$22.87

Balance is patient coinsurance

Providers submitted an average of $95.69 for this code and Medicare allowed $28.86 — 3.3× 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 $22.87 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $34.65
Hospital / facility: $23.11

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. 209,840 services were billed in an office setting and 210,979 in a facility.

Services: 420,819
Beneficiaries: 49,222
Providers billing it: 2,115
Total allowed: $12,144,836

What Medicare pays for CPT 11045

Across 420,819 services billed by 2,115 providers to 49,222 beneficiaries, Medicare allowed an average of $28.86 per service. That is 8.5 services per beneficiary, so this is a code patients typically receive more than once. 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 11045

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	159,385	19,919	$27.23	913
General Surgery	49,050	5,886	$29.55	238
Physician Assistant	46,324	5,242	$30.35	199
Podiatry	30,409	2,219	$34.11	111
Family Practice	28,517	4,091	$27.38	185
Internal Medicine	25,461	2,897	$30.43	101
Emergency Medicine	17,638	2,193	$25.28	94
Undersea and Hyperbaric Medicine	11,921	732	$32.40	26
Vascular Surgery	10,510	1,029	$26.90	50
Plastic and Reconstructive Surgery	7,995	875	$26.76	42
General Practice	6,162	1,001	$34.62	32
Pediatric Medicine	4,354	285	$34.70	5
Infectious Disease	4,348	572	$26.14	30
Orthopedic Surgery	3,853	299	$31.90	11
Physical Medicine and Rehabilitation	2,639	376	$28.12	15

11045 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
California	92,290	$34.52	$25.47	297
Florida	45,962	$29.44	$22.60	255
Texas	34,680	$30.18	$24.28	153
Ohio	14,800	$25.88	$21.03	88
Illinois	13,678	$27.69	$20.75	79
New York	13,202	$29.74	$21.58	66
Mississippi	12,614	$27.92	$23.91	59
North Carolina	11,595	$21.86	$18.26	64
Massachusetts	11,398	$27.04	$20.81	54
New Jersey	10,782	$29.79	$22.00	84
Kansas	9,765	$29.15	$25.68	24
Maryland	9,742	$27.36	$20.55	71
Georgia	9,043	$29.32	$23.14	47
Indiana	8,517	$23.04	$19.58	56
Virginia	8,452	$23.92	$18.77	57
Arizona	8,083	$27.93	$22.25	35
Louisiana	8,082	$28.23	$23.63	49
Kentucky	7,627	$23.58	$18.71	27
Tennessee	7,500	$26.00	$21.89	53
South Carolina	7,342	$25.79	$21.23	39
Pennsylvania	7,204	$26.08	$20.48	49
Oklahoma	7,200	$26.87	$22.62	31
Missouri	7,188	$27.34	$21.61	42
Washington	6,681	$25.67	$20.23	26
Nevada	5,628	$25.61	$20.84	34
Connecticut	5,271	$30.17	$22.42	26
Michigan	4,615	$24.79	$18.88	33
Alabama	3,935	$24.80	$20.94	24
Arkansas	3,592	$22.71	$19.56	31
Iowa	2,949	$20.43	$17.33	20
Delaware	2,516	$22.86	$18.21	7
Minnesota	1,980	$22.99	$18.86	13
Hawaii	1,927	$26.52	$20.95	11
Rhode Island	1,843	$24.76	$19.35	5
Wisconsin	1,777	$21.14	$17.81	20
Maine	1,481	$33.18	$25.63	3
West Virginia	1,343	$25.59	$19.76	10
District of Columbia	1,338	$32.59	$24.51	6
Nebraska	1,303	$21.68	$18.66	10
Colorado	941	$22.68	$17.91	11
Montana	907	$23.45	$18.41	9
Idaho	780	$21.28	$18.00	6
New Mexico	752	$29.51	$22.78	5
New Hampshire	548	$24.02	$18.89	6
Oregon	543	$20.56	$16.53	6
South Dakota	458	$20.26	$17.39	5
Utah	336	$26.01	$20.18	3
AE	181	$22.19	$16.61	1
Alaska	160	$32.00	$18.37	1
North Dakota	154	$19.78	$16.58	3
Guam	134	$25.07	$19.56	1

Related codes

11042Removal of skin and tissue$84.31
11056Removal of noncancer thickened skin growth$79.85
11055Removal of noncancer thickened skin growth$66.64
11043Removal of muscle and/or tissue$193.00
11057Removal of noncancer thickened skin growth$87.46
11046Removal of muscle and/or tissue$62.70
11044Removal of bone$273.61
11047Removal of bone$109.02
11000Removal of inflamed or infected skin$50.90

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.