How much does Medicare pay for CPT 11423?

Medicare allowed an average of $166.91 per service and paid $130.69 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $373.91, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11423?

Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm. It was billed 1,167 times to 888 Medicare beneficiaries by 44 providers in 2024.

Does 11423 pay differently in an office than a hospital?

Yes. The allowed amount averaged $168.01 in an office setting and $76.33 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 11423 most?

Dermatology, with 483 services from 26 clinicians. Next are Podiatry, Internal Medicine, Plastic and Reconstructive Surgery.

CPT 11423

Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm

$166.91Medicare-allowed amount per service, averaged across 1,167 services

Providers submitted

$373.91

Asking price, not received

Medicare allowed

$166.91

The fee schedule figure

Medicare paid

$130.69

Balance is patient coinsurance

Providers submitted an average of $373.91 for this code and Medicare allowed $166.91 — 2.2× 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 $130.69 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $168.01
Hospital / facility: $76.33

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. 1,153 services were billed in an office setting and 14 in a facility.

Services: 1,167
Beneficiaries: 888
Providers billing it: 44
Total allowed: $194,784

What Medicare pays for CPT 11423

Across 1,167 services billed by 44 providers to 888 beneficiaries, Medicare allowed an average of $166.91 per service. That is 1.3 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 11423

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	483	435	$142.99	26
Podiatry	397	287	$204.32	9
Internal Medicine	179	67	$185.99	2
Plastic and Reconstructive Surgery	43	41	$100.04	3
Micrographic Dermatologic Surgery	26	26	$112.58	2
General Surgery	25	19	$120.89	1
Otolaryngology	14	13	$76.33	1

11423 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	207	$187.53	$139.21	8
North Carolina	147	$190.18	$159.87	1
Texas	144	$195.90	$157.42	4
Massachusetts	91	$187.78	$128.32	2
Virginia	86	$110.70	$84.88	2
California	83	$142.57	$86.74	4
New York	75	$163.97	$110.05	3
Illinois	75	$191.16	$145.39	3
Pennsylvania	44	$117.86	$91.63	3
Nevada	43	$169.32	$137.67	2
New Jersey	38	$112.28	$77.94	3
Arizona	33	$168.39	$131.86	2
South Carolina	33	$98.56	$80.75	2
Mississippi	20	$167.30	$132.94	1
New Hampshire	12	$103.94	$80.90	1
Maryland	12	$95.08	$80.57	1
Georgia	12	$92.28	$82.37	1
Louisiana	12	$195.38	$150.14	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
11404Removal of noncancer skin growth of body$151.01
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.