How much does Medicare pay for CPT 11404?

Medicare allowed an average of $151.01 per service and paid $117.62 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $540.00, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11404?

Removal of noncancer skin growth of body, arms, or legs, 3.1-4.0 cm. It was billed 1,434 times to 1,264 Medicare beneficiaries by 74 providers in 2024.

Does 11404 pay differently in an office than a hospital?

Yes. The allowed amount averaged $135.75 in an office setting and $348.18 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 11404 most?

Dermatology, with 904 services from 42 clinicians. Next are Plastic and Reconstructive Surgery, Physician Assistant, General Surgery.

CPT 11404

Removal of noncancer skin growth of body, arms, or legs, 3.1-4.0 cm

$151.01Medicare-allowed amount per service, averaged across 1,434 services

Providers submitted

$540.00

Asking price, not received

Medicare allowed

$151.01

The fee schedule figure

Medicare paid

$117.62

Balance is patient coinsurance

Providers submitted an average of $540.00 for this code and Medicare allowed $151.01 — 3.6× 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 $117.62 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $135.75
Hospital / facility: $348.18

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 1,331 services were billed in an office setting and 103 in a facility.

Services: 1,434
Beneficiaries: 1,264
Providers billing it: 74
Total allowed: $216,548

What Medicare pays for CPT 11404

Across 1,434 services billed by 74 providers to 1,264 beneficiaries, Medicare allowed an average of $151.01 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 11404

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	904	775	$138.75	42
Plastic and Reconstructive Surgery	162	150	$106.07	10
Physician Assistant	118	116	$119.24	7
General Surgery	94	92	$141.38	6
Family Practice	53	35	$147.29	2
Ambulatory Surgical Center	49	46	$642.19	3
Micrographic Dermatologic Surgery	27	26	$117.30	2
Nurse Practitioner	14	12	$180.27	1
Internal Medicine	13	12	$123.94	1

11404 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	298	$190.11	$126.74	13
Florida	218	$145.27	$104.48	14
Virginia	172	$133.39	$100.16	3
Pennsylvania	119	$130.42	$100.68	6
New York	109	$127.35	$83.53	7
Arkansas	75	$272.47	$257.04	5
New Jersey	58	$113.92	$85.17	4
Illinois	58	$122.83	$89.62	2
Texas	58	$136.12	$108.37	4
Tennessee	46	$136.96	$111.02	2
Massachusetts	42	$163.98	$100.52	3
Connecticut	42	$111.30	$78.62	2
Nevada	40	$137.35	$108.06	2
Georgia	30	$95.81	$78.39	2
Maryland	26	$112.11	$82.36	2
New Hampshire	15	$108.21	$89.52	1
Indiana	15	$115.10	$94.23	1
South Carolina	13	$101.58	$87.68	1

Related codes

11402Removal of noncancer skin growth of body$95.28
11401Removal of noncancer skin growth of body$104.57
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
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.