How much does Medicare pay for CPT 11105?

Medicare allowed an average of $51.22 per service and paid $39.83 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $147.84, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11105?

Punch biopsy, each additional skin growth. It was billed 33,149 times to 22,481 Medicare beneficiaries by 996 providers in 2024.

Does 11105 pay differently in an office than a hospital?

Yes. The allowed amount averaged $53.88 in an office setting and $23.99 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 11105 most?

Dermatology, with 13,337 services from 437 clinicians. Next are Neurology, Physician Assistant, Nurse Practitioner.

CPT 11105

Punch biopsy, each additional skin growth

$51.22Medicare-allowed amount per service, averaged across 33,149 services

Providers submitted

$147.84

Asking price, not received

Medicare allowed

$51.22

The fee schedule figure

Medicare paid

$39.83

Balance is patient coinsurance

Providers submitted an average of $147.84 for this code and Medicare allowed $51.22 — 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 $39.83 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $53.88
Hospital / facility: $23.99

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. 30,203 services were billed in an office setting and 2,946 in a facility.

Services: 33,149
Beneficiaries: 22,481
Providers billing it: 996
Total allowed: $1,697,892

What Medicare pays for CPT 11105

Across 33,149 services billed by 996 providers to 22,481 beneficiaries, Medicare allowed an average of $51.22 per service. That is 1.5 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 11105

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	13,337	9,825	$55.35	437
Neurology	7,447	4,031	$53.52	167
Physician Assistant	5,377	3,969	$44.88	180
Nurse Practitioner	4,722	3,113	$41.51	141
Podiatry	735	634	$54.84	28
Plastic and Reconstructive Surgery	526	273	$55.54	13
Internal Medicine	305	174	$56.56	6
Family Practice	148	122	$54.35	5
Micrographic Dermatologic Surgery	132	106	$60.86	4
Interventional Pain Management	116	37	$52.67	2
Otolaryngology	52	32	$59.80	2
General Surgery	52	25	$31.93	2
Rheumatology	41	27	$44.73	2
Anesthesiology	33	25	$57.19	1
Psychiatry	32	16	$27.02	1

11105 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	5,260	$56.69	$44.27	134
California	3,433	$57.75	$40.51	104
Texas	2,079	$53.68	$43.38	57
Massachusetts	1,692	$51.38	$37.17	39
Illinois	1,659	$52.57	$40.79	53
Arizona	1,456	$50.59	$41.27	45
Virginia	1,276	$49.83	$38.13	37
North Carolina	1,203	$40.77	$33.06	36
Indiana	1,203	$42.26	$33.81	21
Maryland	1,167	$48.37	$35.55	34
Washington	897	$47.45	$33.73	30
Tennessee	887	$47.93	$39.59	28
New York	819	$55.71	$41.09	35
South Carolina	749	$48.59	$39.85	29
Pennsylvania	716	$47.45	$36.85	24
New Jersey	680	$59.60	$45.38	18
Alabama	663	$49.38	$44.09	18
Kentucky	628	$50.40	$42.14	22
Michigan	617	$47.03	$36.38	16
Georgia	470	$51.10	$42.02	16
Ohio	457	$36.04	$29.60	16
Kansas	416	$44.09	$36.79	17
Delaware	399	$44.91	$34.51	7
Wisconsin	391	$46.89	$37.85	16
District of Columbia	367	$65.08	$42.63	7
Missouri	326	$39.83	$32.19	14
West Virginia	321	$47.58	$40.37	14
Iowa	237	$48.74	$40.93	8
Oregon	232	$51.21	$38.36	10
Minnesota	225	$49.15	$39.35	8
Idaho	204	$49.78	$41.43	4
Nevada	196	$53.25	$41.76	5
Mississippi	195	$51.85	$46.05	6
Colorado	190	$47.42	$36.52	8
Connecticut	177	$57.05	$40.84	7
Wyoming	175	$58.02	$44.19	3
Arkansas	175	$39.96	$35.42	8
New Hampshire	150	$28.54	$22.09	5
Louisiana	148	$32.31	$26.68	5
Utah	140	$45.33	$36.15	7
Oklahoma	91	$48.83	$40.81	5
Nebraska	73	$53.88	$45.98	4
Montana	69	$52.54	$40.27	4
New Mexico	66	$51.69	$45.50	2
North Dakota	53	$22.75	$17.18	3
Maine	38	$56.61	$47.29	1
Hawaii	31	$56.14	$44.41	2
Alaska	15	$56.89	$40.33	1
Vermont	15	$23.86	$19.81	1
Rhode Island	12	$60.26	$46.66	1
South Dakota	11	$57.25	$42.43	1

Related codes

11102Biopsy of related skin growth$83.12
11103Biopsy of related skin growth$46.68
11104Punch biopsy, first skin growth$108.60
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.