How much does Medicare pay for CPT 11047?

Medicare allowed an average of $109.02 per service and paid $87.34 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $312.42, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11047?

Removal of bone, each additional 20.0 sq cm or less. It was billed 43,391 times to 3,529 Medicare beneficiaries by 150 providers in 2024.

Does 11047 pay differently in an office than a hospital?

Yes. The allowed amount averaged $124.19 in an office setting and $96.66 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 11047 most?

General Surgery, with 12,840 services from 40 clinicians. Next are Nurse Practitioner, Plastic and Reconstructive Surgery, General Practice.

CPT 11047

Removal of bone, each additional 20.0 sq cm or less

$109.02Medicare-allowed amount per service, averaged across 43,391 services

Providers submitted

$312.42

Asking price, not received

Medicare allowed

$109.02

The fee schedule figure

Medicare paid

$87.34

Balance is patient coinsurance

Providers submitted an average of $312.42 for this code and Medicare allowed $109.02 — 2.9× 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 $87.34 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $124.19
Hospital / facility: $96.66

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. 19,479 services were billed in an office setting and 23,912 in a facility.

Services: 43,391
Beneficiaries: 3,529
Providers billing it: 150
Total allowed: $4,730,487

What Medicare pays for CPT 11047

Across 43,391 services billed by 150 providers to 3,529 beneficiaries, Medicare allowed an average of $109.02 per service. That is 12.3 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 11047

Specialty	Services	Beneficiaries	Avg allowed	Providers
General Surgery	12,840	1,092	$113.57	40
Nurse Practitioner	5,114	498	$85.35	26
Plastic and Reconstructive Surgery	4,618	379	$99.24	16
General Practice	3,997	272	$121.87	8
Physician Assistant	3,832	359	$100.71	19
Internal Medicine	2,736	228	$127.28	7
Anesthesiology	2,632	21	$113.05	1
Critical Care (Intensivists)	2,428	55	$99.56	1
Emergency Medicine	1,324	114	$129.23	3
Family Practice	985	179	$111.75	8
Otolaryngology	872	45	$125.80	1
Orthopedic Surgery	648	30	$114.06	1
Podiatry	549	137	$103.84	11
Geriatric Medicine	241	27	$121.88	1
Thoracic Surgery	143	15	$97.71	1

11047 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	9,378	$112.27	$81.96	34
Florida	8,831	$98.02	$74.00	31
New York	5,487	$120.03	$79.82	8
Texas	2,608	$118.59	$90.23	12
Maryland	2,553	$123.27	$85.72	8
Georgia	2,502	$95.34	$76.91	7
Mississippi	1,991	$114.72	$93.55	3
New Jersey	1,429	$118.85	$84.38	6
Virginia	1,125	$105.61	$81.17	3
District of Columbia	1,025	$106.15	$78.16	5
North Carolina	1,003	$77.84	$66.36	7
Alabama	967	$105.04	$87.78	2
Louisiana	867	$86.28	$71.71	5
Pennsylvania	783	$122.73	$91.82	2
Kentucky	655	$95.70	$74.95	1
Arizona	565	$122.93	$94.18	1
Ohio	461	$119.44	$88.37	4
Indiana	447	$122.83	$94.10	1
Massachusetts	203	$96.87	$77.38	2
Illinois	171	$115.72	$85.14	3
Oklahoma	143	$89.60	$75.12	2
West Virginia	128	$98.43	$74.98	1
Michigan	53	$99.28	$74.84	1
Connecticut	16	$131.17	$93.89	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
11045Removal of skin and tissue$28.86
11057Removal of noncancer thickened skin growth$87.46
11046Removal of muscle and/or tissue$62.70
11044Removal of bone$273.61
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.