How much does Medicare pay for CPT 11106?

Medicare allowed an average of $139.34 per service and paid $103.69 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $288.17, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11106?

Incision biopsy, first skin growth. It was billed 20,352 times to 17,190 Medicare beneficiaries by 269 providers in 2024.

Does 11106 pay differently in an office than a hospital?

Yes. The allowed amount averaged $140.00 in an office setting and $47.84 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 11106 most?

Dermatology, with 13,305 services from 154 clinicians. Next are Physician Assistant, Plastic and Reconstructive Surgery, Micrographic Dermatologic Surgery.

CPT 11106

Incision biopsy, first skin growth

$139.34Medicare-allowed amount per service, averaged across 20,352 services

Providers submitted

$288.17

Asking price, not received

Medicare allowed

$139.34

The fee schedule figure

Medicare paid

$103.69

Balance is patient coinsurance

Providers submitted an average of $288.17 for this code and Medicare allowed $139.34 — 2.1× 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 $103.69 (74%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $140.00
Hospital / facility: $47.84

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. 20,207 services were billed in an office setting and 145 in a facility.

Services: 20,352
Beneficiaries: 17,190
Providers billing it: 269
Total allowed: $2,835,848

What Medicare pays for CPT 11106

Across 20,352 services billed by 269 providers to 17,190 beneficiaries, Medicare allowed an average of $139.34 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 11106

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	13,305	11,124	$144.81	154
Physician Assistant	2,793	2,375	$120.28	31
Plastic and Reconstructive Surgery	1,401	1,219	$139.71	20
Micrographic Dermatologic Surgery	932	785	$118.74	8
Nurse Practitioner	560	477	$119.93	19
Podiatry	412	357	$150.71	5
Ophthalmology	330	320	$140.66	13
General Practice	301	236	$174.55	2
Family Practice	137	123	$138.91	7
General Surgery	50	48	$142.17	3
Internal Medicine	49	47	$122.40	3
Ambulatory Surgical Center	34	33	$81.94	1
Otolaryngology	31	30	$71.41	2
Colorectal Surgery (Proctology)	17	16	$88.04	1

11106 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	5,275	$142.00	$104.31	44
California	3,152	$144.32	$98.21	42
New York	1,159	$155.42	$102.84	17
Kentucky	1,027	$119.22	$96.98	11
Texas	1,001	$114.91	$90.18	15
Massachusetts	950	$151.47	$106.36	12
Maryland	942	$146.96	$104.20	9
Pennsylvania	815	$133.67	$98.78	13
New Jersey	790	$157.43	$108.33	13
Tennessee	684	$130.16	$102.61	8
Illinois	599	$135.63	$107.19	4
Virginia	585	$149.77	$106.32	9
Indiana	568	$135.57	$106.62	4
South Carolina	437	$142.56	$102.53	4
Oklahoma	385	$119.88	$97.99	5
Washington	266	$175.73	$110.73	3
Louisiana	226	$128.97	$99.64	4
Michigan	208	$117.16	$94.13	3
North Carolina	172	$131.03	$99.64	9
Hawaii	158	$102.73	$68.35	3
Connecticut	108	$146.36	$98.90	3
Arizona	90	$129.57	$93.90	4
Georgia	89	$94.30	$69.21	4
Nevada	87	$125.89	$95.03	3
Missouri	85	$45.20	$33.95	2
District of Columbia	84	$140.87	$96.23	2
Oregon	80	$151.61	$102.94	4
New Hampshire	71	$154.84	$115.60	1
Delaware	58	$137.61	$103.73	2
Ohio	55	$125.90	$99.74	3
Wisconsin	33	$86.77	$61.74	2
Mississippi	32	$117.18	$105.25	2
Arkansas	26	$105.32	$96.62	1
Colorado	23	$131.21	$96.65	2
Utah	20	$81.22	$67.43	1
Wyoming	12	$149.73	$115.43	1

Related codes

11102Biopsy of related skin growth$83.12
11103Biopsy of related skin growth$46.68
11104Punch biopsy, first skin growth$108.60
11105Punch biopsy, each additional skin growth$51.22
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.