How much does Medicare pay for CPT 11102?

Medicare allowed an average of $83.12 per service and paid $59.89 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $225.05, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11102?

Biopsy of related skin growth, first growth. It was billed 3,452,445 times to 2,864,172 Medicare beneficiaries by 19,666 providers in 2024.

Does 11102 pay differently in an office than a hospital?

Yes. The allowed amount averaged $84.09 in an office setting and $26.53 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 11102 most?

Dermatology, with 2,205,833 services from 11,011 clinicians. Next are Physician Assistant, Nurse Practitioner, Micrographic Dermatologic Surgery.

CPT 11102

Biopsy of related skin growth, first growth

$83.12Medicare-allowed amount per service, averaged across 3,452,445 services

Providers submitted

$225.05

Asking price, not received

Medicare allowed

$83.12

The fee schedule figure

Medicare paid

$59.89

Balance is patient coinsurance

Providers submitted an average of $225.05 for this code and Medicare allowed $83.12 — 2.7× 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 $59.89 (72%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $84.09
Hospital / facility: $26.53

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. 3,394,311 services were billed in an office setting and 58,134 in a facility.

Services: 3,452,445
Beneficiaries: 2,864,172
Providers billing it: 19,666
Total allowed: $286,967,228

What Medicare pays for CPT 11102

Across 3,452,445 services billed by 19,666 providers to 2,864,172 beneficiaries, Medicare allowed an average of $83.12 per service. That is 1.2 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 11102

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	2,205,833	1,800,919	$88.13	11,011
Physician Assistant	828,621	707,089	$74.02	5,384
Nurse Practitioner	328,440	282,813	$72.49	2,288
Micrographic Dermatologic Surgery	42,770	34,799	$79.92	334
Family Practice	17,076	14,074	$86.96	235
Internal Medicine	7,744	6,472	$85.30	81
Plastic and Reconstructive Surgery	5,613	4,618	$85.01	107
Pathology	2,991	2,484	$87.19	25
General Practice	2,837	1,796	$83.21	15
Podiatry	2,346	2,160	$82.47	79
Otolaryngology	1,570	1,374	$88.38	45
Undefined Physician type	1,251	985	$78.36	9
Pediatric Medicine	1,041	826	$91.03	8
Osteopathic Manipulative Medicine	790	656	$88.11	5
General Surgery	713	646	$76.34	7

11102 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
Florida	531,198	$82.07	$60.01	2,025
California	323,543	$94.10	$59.67	1,825
Texas	226,651	$81.34	$59.62	1,314
New York	192,062	$97.75	$63.40	1,299
Pennsylvania	143,263	$81.59	$58.28	827
North Carolina	121,961	$78.07	$58.31	743
Arizona	121,767	$81.57	$57.96	513
Georgia	120,697	$79.65	$59.66	579
New Jersey	115,606	$97.25	$63.47	621
Virginia	105,409	$84.56	$59.57	516
Illinois	104,853	$82.75	$58.22	706
Massachusetts	95,222	$89.87	$59.73	616
Tennessee	83,535	$74.01	$57.52	435
Ohio	82,169	$76.26	$57.42	636
South Carolina	78,718	$77.80	$59.24	290
Maryland	70,720	$90.54	$60.17	401
Michigan	61,353	$80.45	$58.87	517
Washington	58,444	$81.80	$54.31	419
Colorado	56,514	$87.40	$59.93	388
Missouri	52,016	$76.93	$58.23	329
Indiana	51,934	$76.49	$57.00	325
Alabama	49,436	$74.02	$59.52	282
Kentucky	39,493	$76.53	$60.37	231
Connecticut	37,518	$94.79	$62.54	291
Oregon	36,311	$82.08	$56.36	256
Wisconsin	34,998	$67.93	$49.48	308
Arkansas	32,595	$68.59	$55.42	148
Louisiana	32,497	$76.81	$60.80	229
Oklahoma	32,466	$74.44	$58.00	162
Kansas	31,804	$76.06	$58.62	160
Minnesota	31,666	$75.34	$52.19	350
Mississippi	28,923	$74.29	$60.79	136
Iowa	28,915	$72.00	$54.63	179
Utah	25,820	$77.29	$56.48	221
Nevada	23,903	$80.52	$57.33	152
New Hampshire	20,180	$74.26	$50.57	110
New Mexico	17,430	$76.82	$57.56	85
Idaho	17,159	$72.04	$52.82	130
Nebraska	17,007	$72.86	$55.09	104
Delaware	15,765	$85.26	$60.87	58
West Virginia	13,515	$69.17	$53.67	108
South Dakota	13,480	$58.35	$43.34	80
Rhode Island	13,343	$83.38	$58.04	103
Montana	12,757	$78.30	$53.30	75
Maine	10,747	$82.18	$59.01	77
Wyoming	7,127	$77.80	$53.52	37
Hawaii	6,771	$90.26	$58.75	62
Vermont	6,305	$66.91	$46.14	44
North Dakota	6,214	$47.59	$34.07	49
District of Columbia	4,716	$94.11	$61.22	46
Alaska	3,886	$98.28	$62.73	25
Puerto Rico	1,835	$92.41	$66.87	42
Guam	167	$94.96	$68.71	1
U.S. Virgin Islands	61	$89.67	$61.76	1

Related codes

11103Biopsy of related skin growth$46.68
11104Punch biopsy, first skin growth$108.60
11105Punch biopsy, each additional skin growth$51.22
11106Incision biopsy$139.34
11107Incision biopsy$68.45

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.