How much does Medicare pay for CPT 11056?

Medicare allowed an average of $79.85 per service and paid $58.79 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $134.05, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11056?

Removal of noncancer thickened skin growth, 2-4 growths. It was billed 1,795,220 times to 771,537 Medicare beneficiaries by 8,318 providers in 2024.

Does 11056 pay differently in an office than a hospital?

Yes. The allowed amount averaged $81.36 in an office setting and $21.01 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 11056 most?

Podiatry, with 1,764,409 services from 8,118 clinicians. Next are Nurse Practitioner, Physician Assistant, Orthopedic Surgery.

CPT 11056

Removal of noncancer thickened skin growth, 2-4 growths

$79.85Medicare-allowed amount per service, averaged across 1,795,220 services

Providers submitted

$134.05

Asking price, not received

Medicare allowed

$79.85

The fee schedule figure

Medicare paid

$58.79

Balance is patient coinsurance

Providers submitted an average of $134.05 for this code and Medicare allowed $79.85 — 1.7× 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 $58.79 (74%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $81.36
Hospital / facility: $21.01

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. 1,750,213 services were billed in an office setting and 45,007 in a facility.

Services: 1,795,220
Beneficiaries: 771,537
Providers billing it: 8,318
Total allowed: $143,348,317

What Medicare pays for CPT 11056

Across 1,795,220 services billed by 8,318 providers to 771,537 beneficiaries, Medicare allowed an average of $79.85 per service. That is 2.3 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 11056

Specialty	Services	Beneficiaries	Avg allowed	Providers
Podiatry	1,764,409	752,170	$80.14	8,118
Nurse Practitioner	25,672	16,252	$64.02	142
Physician Assistant	3,392	2,104	$62.61	32
Orthopedic Surgery	702	328	$27.87	3
General Surgery	210	165	$45.05	2
Pain Management	204	93	$74.41	1
Internal Medicine	138	106	$68.09	4
Family Practice	111	90	$71.82	3
Cardiac Surgery	83	38	$20.99	1
Emergency Medicine	66	39	$19.56	3
Preventive Medicine	63	31	$93.51	1
Certified Clinical Nurse Specialist	41	24	$63.57	2
Infectious Disease	35	13	$75.28	1
Unknown Supplier/Provider Specialty	26	22	$36.42	1
Dermatology	24	21	$56.30	1

11056 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	289,425	$84.87	$56.35	1,017
New York	202,700	$87.99	$59.57	765
Pennsylvania	165,416	$77.15	$57.70	627
New Jersey	142,881	$87.12	$59.57	539
Florida	131,040	$76.34	$58.05	525
Illinois	116,301	$75.24	$56.38	416
Massachusetts	72,521	$82.05	$57.94	218
Maryland	71,301	$84.25	$58.04	262
Texas	47,592	$74.32	$57.14	341
Virginia	40,875	$77.21	$56.24	206
Ohio	40,272	$73.15	$56.41	336
Michigan	36,599	$76.38	$57.94	265
Arizona	35,863	$76.26	$57.61	228
North Carolina	30,780	$72.94	$56.87	198
Connecticut	27,784	$84.70	$58.35	129
Missouri	26,064	$71.09	$54.97	137
Georgia	25,407	$73.93	$57.55	190
Washington	23,978	$81.03	$55.27	159
Indiana	21,619	$71.03	$56.36	143
Utah	16,307	$75.29	$56.77	104
Tennessee	15,755	$70.95	$57.68	129
Kansas	15,017	$65.71	$52.30	57
South Carolina	14,510	$73.73	$57.30	83
Iowa	13,883	$69.59	$53.75	97
Wisconsin	13,765	$73.15	$54.67	116
Rhode Island	13,667	$80.82	$57.30	60
Delaware	13,552	$79.03	$58.79	43
Oregon	13,340	$78.80	$56.43	89
Kentucky	12,764	$68.58	$55.83	90
Nevada	11,491	$73.72	$55.64	57
Minnesota	10,768	$78.62	$55.80	79
Colorado	10,587	$75.84	$53.59	83
Oklahoma	8,274	$69.76	$58.21	56
Alabama	6,953	$69.48	$56.69	57
Montana	5,667	$72.91	$51.99	33
Louisiana	5,447	$64.81	$52.48	59
New Mexico	4,855	$73.91	$56.79	38
Arkansas	4,742	$69.74	$59.22	40
Idaho	4,735	$69.24	$53.91	36
Nebraska	4,436	$66.42	$54.44	37
Maine	3,818	$78.34	$55.40	17
West Virginia	3,803	$68.70	$54.07	30
South Dakota	3,418	$62.30	$45.18	20
New Hampshire	2,853	$79.24	$58.18	18
Mississippi	2,803	$64.07	$54.51	15
District of Columbia	2,355	$91.16	$59.63	16
Wyoming	2,225	$83.10	$55.96	8
North Dakota	1,574	$51.27	$36.75	21
Hawaii	1,525	$86.18	$58.99	14
Vermont	821	$70.24	$51.47	8
XX	772	$81.90	$62.36	1
Alaska	320	$73.42	$44.44	6

Related codes

11042Removal of skin and tissue$84.31
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
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.