How much does Medicare pay for CPT 11422?

Medicare allowed an average of $133.43 per service and paid $102.25 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $374.41, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11422?

Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm. It was billed 6,745 times to 4,891 Medicare beneficiaries by 196 providers in 2024.

Does 11422 pay differently in an office than a hospital?

Yes. The allowed amount averaged $137.49 in an office setting and $88.34 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 11422 most?

Dermatology, with 3,082 services from 111 clinicians. Next are Podiatry, Plastic and Reconstructive Surgery, General Surgery.

CPT 11422

Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm

$133.43Medicare-allowed amount per service, averaged across 6,745 services

Providers submitted

$374.41

Asking price, not received

Medicare allowed

$133.43

The fee schedule figure

Medicare paid

$102.25

Balance is patient coinsurance

Providers submitted an average of $374.41 for this code and Medicare allowed $133.43 — 2.8× 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 $102.25 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $137.49
Hospital / facility: $88.34

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. 6,188 services were billed in an office setting and 557 in a facility.

Services: 6,745
Beneficiaries: 4,891
Providers billing it: 196
Total allowed: $899,985

What Medicare pays for CPT 11422

Across 6,745 services billed by 196 providers to 4,891 beneficiaries, Medicare allowed an average of $133.43 per service. That is 1.4 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 11422

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	3,082	2,511	$129.49	111
Podiatry	1,983	1,050	$170.15	25
Plastic and Reconstructive Surgery	526	417	$98.68	20
General Surgery	227	186	$93.79	3
Ambulatory Surgical Center	203	170	$58.01	7
Micrographic Dermatologic Surgery	199	185	$122.00	11
Internal Medicine	198	86	$96.52	2
Physician Assistant	137	129	$94.88	8
General Practice	59	31	$135.62	1
Nurse Practitioner	53	49	$106.73	3
Family Practice	49	48	$113.30	3
Undefined Physician type	15	15	$110.85	1
Orthopedic Surgery	14	14	$89.46	1

11422 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	1,360	$132.83	$87.78	27
Massachusetts	879	$170.21	$112.73	6
New York	707	$154.35	$101.63	12
Florida	523	$147.60	$106.74	21
Pennsylvania	370	$145.75	$111.08	9
Texas	338	$130.02	$99.92	16
Indiana	331	$83.12	$71.01	8
Illinois	237	$123.74	$90.59	12
Arkansas	208	$136.02	$107.98	3
North Carolina	205	$84.58	$68.76	5
Georgia	194	$79.93	$67.74	6
Nevada	147	$149.70	$114.12	4
Virginia	129	$101.07	$79.14	7
Ohio	127	$116.11	$92.48	7
New Jersey	127	$147.55	$107.02	5
Maryland	124	$128.08	$91.00	8
Arizona	112	$132.95	$103.75	4
Mississippi	70	$96.70	$80.12	5
South Carolina	58	$141.65	$113.35	3
Puerto Rico	58	$134.89	$104.90	1
Colorado	53	$98.61	$72.59	2
Tennessee	42	$107.51	$91.06	3
Wisconsin	31	$126.01	$101.77	2
Nebraska	31	$103.78	$86.38	2
Missouri	29	$63.79	$53.14	2
Minnesota	29	$129.87	$95.31	2
District of Columbia	28	$101.46	$70.34	1
Oregon	28	$124.60	$88.16	2
Alabama	25	$133.24	$89.52	1
Connecticut	19	$97.51	$68.40	1
Louisiana	17	$95.89	$78.76	1
Michigan	16	$77.60	$50.95	1
Kentucky	14	$92.74	$75.47	1
West Virginia	14	$88.08	$66.34	1
South Dakota	14	$111.37	$76.08	1
Washington	14	$90.32	$70.51	1
New Hampshire	13	$90.58	$70.41	1
Montana	13	$87.97	$70.16	1
Kansas	11	$81.95	$70.49	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
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.