How much does Medicare pay for CPT 11401?

Medicare allowed an average of $104.57 per service and paid $79.59 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $300.86, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11401?

Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm. It was billed 16,105 times to 12,899 Medicare beneficiaries by 505 providers in 2024.

Does 11401 pay differently in an office than a hospital?

Yes. The allowed amount averaged $106.04 in an office setting and $60.44 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 11401 most?

Dermatology, with 10,547 services from 307 clinicians. Next are Physician Assistant, Nurse Practitioner, Plastic and Reconstructive Surgery.

CPT 11401

Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm

$104.57Medicare-allowed amount per service, averaged across 16,105 services

Providers submitted

$300.86

Asking price, not received

Medicare allowed

$104.57

The fee schedule figure

Medicare paid

$79.59

Balance is patient coinsurance

Providers submitted an average of $300.86 for this code and Medicare allowed $104.57 — 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 $79.59 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $106.04
Hospital / facility: $60.44

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. 15,587 services were billed in an office setting and 518 in a facility.

Services: 16,105
Beneficiaries: 12,899
Providers billing it: 505
Total allowed: $1,684,100

What Medicare pays for CPT 11401

Across 16,105 services billed by 505 providers to 12,899 beneficiaries, Medicare allowed an average of $104.57 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 11401

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	10,547	8,291	$110.50	307
Physician Assistant	3,047	2,550	$89.43	117
Nurse Practitioner	880	742	$100.56	33
Plastic and Reconstructive Surgery	537	434	$88.68	17
Family Practice	270	194	$127.46	8
General Surgery	231	199	$73.93	7
Micrographic Dermatologic Surgery	167	152	$96.44	4
Ambulatory Surgical Center	137	119	$56.53	5
General Practice	125	58	$103.79	1
Podiatry	71	71	$164.65	1
Cardiology	32	32	$123.25	1
Internal Medicine	30	29	$115.52	2
Orthopedic Surgery	16	15	$76.84	1
Otolaryngology	15	13	$96.67	1

11401 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	3,733	$105.44	$71.23	48
Florida	1,811	$106.00	$79.64	72
Illinois	1,113	$104.04	$75.96	34
Maryland	890	$134.89	$90.47	21
New York	765	$119.55	$87.89	28
Texas	586	$86.81	$68.71	21
Georgia	528	$91.01	$73.24	14
Arizona	518	$89.49	$69.61	21
Indiana	484	$87.00	$71.08	9
Virginia	468	$110.32	$75.86	19
New Jersey	449	$110.76	$75.54	15
Massachusetts	432	$110.93	$74.93	12
Ohio	424	$102.00	$83.42	16
Pennsylvania	423	$110.67	$77.73	19
North Carolina	396	$110.43	$85.00	17
West Virginia	256	$65.17	$54.16	10
Wisconsin	226	$92.71	$69.35	9
South Carolina	224	$87.93	$70.33	12
Kentucky	205	$69.00	$58.62	6
Michigan	190	$124.11	$95.68	8
Alabama	178	$112.71	$94.14	8
Kansas	173	$111.48	$80.07	6
Oregon	146	$110.00	$74.59	4
Missouri	146	$103.10	$82.15	6
Oklahoma	136	$91.95	$74.91	9
Mississippi	118	$93.23	$76.55	6
Louisiana	111	$93.78	$76.76	6
Delaware	111	$95.49	$71.34	4
Nevada	105	$113.31	$82.07	3
Minnesota	101	$89.38	$68.08	6
Hawaii	78	$143.68	$99.20	3
Iowa	68	$100.44	$78.95	4
Tennessee	64	$104.61	$89.38	5
Arkansas	58	$102.36	$81.35	3
Nebraska	52	$115.00	$99.51	3
Connecticut	50	$136.46	$100.44	3
Washington	47	$82.48	$62.88	2
South Dakota	44	$74.74	$60.34	2
Idaho	39	$72.44	$63.32	2
North Dakota	39	$107.19	$70.54	2
Colorado	30	$83.66	$59.41	1
New Mexico	27	$130.90	$92.51	2
District of Columbia	26	$117.14	$80.24	2
ZZ	25	$78.78	$61.38	1
Alaska	12	$91.47	$88.10	1

Related codes

11402Removal of noncancer skin growth of body$95.28
11403Removal of noncancer skin growth of body$113.00
11422Removal of noncancer skin growth of scalp$133.43
11442Removal of noncancer skin growth of face$128.75
11421Removal of noncancer skin growth of scalp$127.16
11440Removal of noncancer skin growth of face$102.78
11420Removal of noncancer skin growth of scalp$109.75
11441Removal of noncancer skin growth of face$118.75
11400Removal of noncancer skin growth of body$100.81
11404Removal of noncancer skin growth of body$151.01
11423Removal of noncancer skin growth of scalp$166.91
11406Removal of noncancer skin growth of body$212.80

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.