How much does Medicare pay for CPT 11200?

Medicare allowed an average of $61.37 per service and paid $43.52 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $190.79, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11200?

Removal of skin tag, 1-15 skin tags. It was billed 39,191 times to 37,010 Medicare beneficiaries by 1,662 providers in 2024.

Does 11200 pay differently in an office than a hospital?

Yes. The allowed amount averaged $61.28 in an office setting and $67.60 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 11200 most?

Dermatology, with 21,315 services from 876 clinicians. Next are Physician Assistant, Nurse Practitioner, Internal Medicine.

CPT 11200

Removal of skin tag, 1-15 skin tags

$61.37Medicare-allowed amount per service, averaged across 39,191 services

Providers submitted

$190.79

Asking price, not received

Medicare allowed

$61.37

The fee schedule figure

Medicare paid

$43.52

Balance is patient coinsurance

Providers submitted an average of $190.79 for this code and Medicare allowed $61.37 — 3.1× 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 $43.52 (71%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $61.28
Hospital / facility: $67.60

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 38,658 services were billed in an office setting and 533 in a facility.

Services: 39,191
Beneficiaries: 37,010
Providers billing it: 1,662
Total allowed: $2,405,152

What Medicare pays for CPT 11200

Across 39,191 services billed by 1,662 providers to 37,010 beneficiaries, Medicare allowed an average of $61.37 per service. 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 11200

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	21,315	20,308	$65.84	876
Physician Assistant	10,456	9,965	$54.53	474
Nurse Practitioner	6,216	5,687	$55.17	258
Internal Medicine	382	318	$82.05	15
Family Practice	379	343	$67.32	17
Plastic and Reconstructive Surgery	135	130	$62.47	5
Micrographic Dermatologic Surgery	87	86	$61.35	5
Podiatry	75	33	$95.25	2
Ophthalmology	38	38	$84.08	3
Pediatric Medicine	23	19	$64.35	1
Interventional Pain Management	18	18	$73.27	1
Pathology	15	15	$60.40	1
Thoracic Surgery	15	15	$32.30	1
Anesthesiology	13	12	$99.44	1
Cardiology	12	11	$104.40	1

11200 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	5,021	$60.78	$43.45	189
California	4,109	$66.52	$43.44	147
Virginia	2,022	$66.24	$47.12	84
Illinois	2,006	$62.32	$44.42	96
Ohio	1,495	$60.73	$45.77	68
Maryland	1,394	$71.28	$47.64	50
Alabama	1,332	$54.58	$43.63	55
Kansas	1,281	$55.34	$41.01	47
Washington	1,274	$61.71	$42.47	56
Indiana	1,244	$61.07	$45.10	48
Pennsylvania	1,228	$60.58	$43.22	47
Texas	1,166	$60.29	$43.53	55
Michigan	1,154	$61.83	$45.30	52
Tennessee	1,074	$57.80	$44.16	49
Iowa	1,005	$59.24	$43.33	51
Georgia	989	$54.21	$41.37	39
New York	968	$68.73	$47.36	41
Arizona	926	$59.13	$42.26	42
Missouri	865	$58.99	$44.36	44
Mississippi	835	$55.13	$44.37	28
South Carolina	797	$58.09	$45.11	27
Minnesota	720	$62.42	$42.30	44
Nebraska	552	$55.01	$42.28	24
Massachusetts	422	$72.07	$49.17	19
Wisconsin	420	$59.88	$45.02	22
Oregon	377	$59.42	$40.46	17
Louisiana	371	$60.35	$47.14	14
Colorado	363	$61.38	$41.28	22
North Carolina	362	$57.85	$44.66	19
Kentucky	337	$57.95	$44.75	16
Oklahoma	333	$56.66	$43.45	17
New Jersey	264	$67.36	$45.45	12
Utah	253	$59.89	$43.36	13
New Hampshire	241	$63.97	$44.53	12
Delaware	232	$59.03	$39.66	7
West Virginia	231	$47.84	$38.04	10
Arkansas	227	$53.13	$42.64	13
South Dakota	211	$56.75	$44.04	12
Nevada	187	$58.08	$39.05	8
North Dakota	164	$61.85	$44.19	9
Maine	157	$64.79	$46.28	8
Wyoming	126	$59.60	$40.69	6
Hawaii	123	$64.44	$45.65	4
New Mexico	93	$57.91	$42.80	5
Montana	74	$68.39	$43.12	5
District of Columbia	54	$72.90	$48.85	2
Idaho	37	$59.24	$43.12	2
Vermont	31	$64.80	$47.88	2
Connecticut	28	$77.48	$54.38	2
Alaska	16	$101.84	$48.68	1

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.