How much does Medicare pay for CPT 11606?

Medicare allowed an average of $351.85 per service and paid $275.95 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1240.18, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11606?

Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm. It was billed 9,496 times to 8,536 Medicare beneficiaries by 383 providers in 2024.

Does 11606 pay differently in an office than a hospital?

Yes. The allowed amount averaged $415.54 in an office setting and $277.45 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 11606 most?

Dermatology, with 2,873 services from 96 clinicians. Next are Surgical Oncology, General Surgery, Plastic and Reconstructive Surgery.

CPT 11606

Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm

$351.85Medicare-allowed amount per service, averaged across 9,496 services

Providers submitted

$1240.18

Asking price, not received

Medicare allowed

$351.85

The fee schedule figure

Medicare paid

$275.95

Balance is patient coinsurance

Providers submitted an average of $1240.18 for this code and Medicare allowed $351.85 — 3.5× 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 $275.95 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $415.54
Hospital / facility: $277.45

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. 5,116 services were billed in an office setting and 4,380 in a facility.

Services: 9,496
Beneficiaries: 8,536
Providers billing it: 383
Total allowed: $3,341,168

What Medicare pays for CPT 11606

Across 9,496 services billed by 383 providers to 8,536 beneficiaries, Medicare allowed an average of $351.85 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 11606

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	2,873	2,469	$435.54	96
Surgical Oncology	1,852	1,727	$238.82	82
General Surgery	1,735	1,623	$259.04	86
Plastic and Reconstructive Surgery	1,347	1,215	$342.35	48
Ambulatory Surgical Center	633	587	$538.71	24
Physician Assistant	310	283	$355.34	16
Nurse Practitioner	218	183	$357.00	10
Otolaryngology	180	163	$403.16	4
Micrographic Dermatologic Surgery	121	116	$448.42	8
Family Practice	97	82	$446.95	4
Ophthalmology	65	33	$219.07	1
Internal Medicine	35	26	$433.03	2
Physical Medicine and Rehabilitation	15	15	$364.41	1
Orthopedic Surgery	15	14	$196.71	1

11606 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	1,706	$401.20	$307.04	52
California	885	$394.60	$282.17	43
New Jersey	637	$397.61	$284.78	19
Illinois	556	$360.02	$287.75	20
Texas	535	$345.09	$278.65	19
Pennsylvania	462	$296.56	$236.11	15
New York	408	$376.39	$254.61	19
Georgia	395	$360.64	$291.01	16
Virginia	344	$349.10	$273.59	17
Tennessee	325	$275.25	$230.69	12
North Carolina	312	$246.24	$200.62	13
Arizona	301	$324.47	$256.61	13
Maryland	262	$433.18	$335.31	11
Ohio	214	$262.88	$215.17	12
Indiana	208	$307.99	$251.98	9
Missouri	183	$318.71	$262.14	6
South Carolina	152	$368.81	$294.78	4
Delaware	124	$401.96	$317.55	7
West Virginia	123	$295.13	$231.69	6
Massachusetts	109	$299.06	$218.60	6
Michigan	106	$283.05	$225.94	6
Alabama	99	$311.81	$269.10	5
Kentucky	99	$257.90	$212.46	5
Minnesota	94	$274.40	$225.49	3
District of Columbia	88	$360.46	$265.36	3
Louisiana	79	$293.55	$224.44	2
Wyoming	73	$471.37	$390.41	3
Kansas	60	$193.56	$154.47	2
Nevada	60	$364.40	$282.42	3
Washington	52	$276.60	$208.10	3
Connecticut	47	$419.76	$297.20	3
Oregon	47	$182.88	$140.24	3
Mississippi	43	$258.03	$234.42	3
Arkansas	39	$340.56	$325.44	3
Hawaii	35	$318.72	$245.42	2
Iowa	35	$339.66	$290.88	3
Oklahoma	33	$314.30	$268.50	2
North Dakota	32	$399.39	$324.79	1
Maine	28	$254.76	$194.85	2
Wisconsin	27	$315.92	$259.97	2
Idaho	19	$341.65	$294.71	1
Utah	18	$157.87	$126.67	1
Rhode Island	17	$284.93	$219.71	1
South Dakota	13	$419.76	$321.19	1
Nebraska	12	$153.07	$143.51	1

Related codes

11602Removal of cancer skin growth of body$124.23
11603Removal of cancer skin growth of body$145.33
11642Removal of cancer skin growth of face$146.34
11622Removal of cancer skin growth of scalp$140.18
11604Removal of cancer skin growth of body$207.87
11643Removal of cancer skin growth of face$186.77
11641Removal of cancer skin growth of face$146.08
11623Removal of cancer skin growth of scalp$165.51
11601Removal of cancer skin growth of body$150.65
11644Removal of cancer skin growth of face$292.35
11646Removal of cancer skin growth of face$427.86
11621Removal of cancer skin growth of scalp$153.64

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.