How much does Medicare pay for CPT 11623?

Medicare allowed an average of $165.51 per service and paid $129.87 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $621.76, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11623?

Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm. It was billed 5,466 times to 5,028 Medicare beneficiaries by 234 providers in 2024.

Does 11623 pay differently in an office than a hospital?

Yes. The allowed amount averaged $172.34 in an office setting and $102.97 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 11623 most?

Dermatology, with 3,964 services from 162 clinicians. Next are Plastic and Reconstructive Surgery, Physician Assistant, Ambulatory Surgical Center.

CPT 11623

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

$165.51Medicare-allowed amount per service, averaged across 5,466 services

Providers submitted

$621.76

Asking price, not received

Medicare allowed

$165.51

The fee schedule figure

Medicare paid

$129.87

Balance is patient coinsurance

Providers submitted an average of $621.76 for this code and Medicare allowed $165.51 — 3.8× 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 $129.87 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $172.34
Hospital / facility: $102.97

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. 4,928 services were billed in an office setting and 538 in a facility.

Services: 5,466
Beneficiaries: 5,028
Providers billing it: 234
Total allowed: $904,678

What Medicare pays for CPT 11623

Across 5,466 services billed by 234 providers to 5,028 beneficiaries, Medicare allowed an average of $165.51 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 11623

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	3,964	3,634	$174.92	162
Plastic and Reconstructive Surgery	602	560	$147.60	28
Physician Assistant	267	252	$135.33	14
Ambulatory Surgical Center	260	242	$87.82	11
Undefined Physician type	67	63	$125.59	1
General Surgery	65	63	$144.62	4
Family Practice	56	51	$217.37	3
Otolaryngology	51	51	$178.39	4
Micrographic Dermatologic Surgery	50	49	$170.16	4
Nurse Practitioner	47	46	$138.91	2
Internal Medicine	37	17	$253.56	1

11623 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	963	$178.84	$138.66	39
Texas	513	$159.29	$123.78	24
California	511	$204.32	$143.29	18
South Carolina	511	$159.44	$129.38	13
Georgia	322	$142.02	$118.33	14
Pennsylvania	209	$169.64	$132.85	12
Maryland	177	$170.56	$129.81	8
Virginia	174	$182.06	$142.00	9
Wyoming	173	$105.19	$85.00	3
Kentucky	169	$131.40	$116.25	5
North Carolina	138	$136.30	$110.67	9
Massachusetts	127	$144.48	$107.68	5
Mississippi	119	$157.48	$133.01	8
Indiana	116	$125.20	$109.11	5
Nebraska	105	$140.33	$115.97	2
New York	104	$213.12	$150.50	4
Alabama	104	$190.45	$161.72	5
Ohio	88	$154.75	$126.12	6
Illinois	87	$256.78	$192.39	3
Arizona	83	$149.44	$117.75	6
District of Columbia	66	$166.29	$115.83	1
Louisiana	61	$178.00	$148.86	4
Missouri	61	$134.02	$117.46	3
Tennessee	55	$189.43	$164.65	3
West Virginia	53	$194.73	$159.94	2
Idaho	51	$158.56	$134.61	3
Michigan	45	$148.73	$118.46	3
Nevada	40	$155.62	$119.90	1
Iowa	36	$136.51	$113.13	2
Delaware	35	$124.23	$94.22	3
Oklahoma	31	$128.31	$110.06	2
Oregon	24	$92.31	$72.58	2
Connecticut	23	$148.09	$115.85	1
New Jersey	18	$186.67	$128.97	1
South Dakota	17	$141.46	$115.92	1
Kansas	17	$150.52	$129.27	1
Colorado	15	$150.39	$116.01	1
North Dakota	13	$137.80	$116.11	1
Wisconsin	12	$245.95	$211.29	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
11606Removal of cancer skin growth of body$351.85
11643Removal of cancer skin growth of face$186.77
11641Removal of cancer skin growth of face$146.08
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.