How much does Medicare pay for CPT 11900?

Medicare allowed an average of $45.52 per service and paid $33.23 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $129.07, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11900?

Injection into skin growth, 1-7 growths. It was billed 162,529 times to 113,794 Medicare beneficiaries by 5,205 providers in 2024.

Does 11900 pay differently in an office than a hospital?

Yes. The allowed amount averaged $45.79 in an office setting and $24.68 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 11900 most?

Dermatology, with 115,236 services from 3,482 clinicians. Next are Physician Assistant, Nurse Practitioner, Ophthalmology.

CPT 11900

Injection into skin growth, 1-7 growths

$45.52Medicare-allowed amount per service, averaged across 162,529 services

Providers submitted

$129.07

Asking price, not received

Medicare allowed

$45.52

The fee schedule figure

Medicare paid

$33.23

Balance is patient coinsurance

Providers submitted an average of $129.07 for this code and Medicare allowed $45.52 — 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 $33.23 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $45.79
Hospital / facility: $24.68

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. 160,440 services were billed in an office setting and 2,089 in a facility.

Services: 162,529
Beneficiaries: 113,794
Providers billing it: 5,205
Total allowed: $7,398,320

What Medicare pays for CPT 11900

Across 162,529 services billed by 5,205 providers to 113,794 beneficiaries, Medicare allowed an average of $45.52 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 11900

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	115,236	80,270	$47.08	3,482
Physician Assistant	24,839	17,839	$39.02	991
Nurse Practitioner	9,169	6,502	$37.68	363
Ophthalmology	4,622	3,814	$53.11	166
Micrographic Dermatologic Surgery	3,112	2,278	$48.33	94
Otolaryngology	1,664	793	$41.14	22
Family Practice	1,474	644	$52.75	18
Plastic and Reconstructive Surgery	738	473	$56.30	19
Internal Medicine	574	337	$44.10	14
General Practice	228	169	$37.92	6
Podiatry	213	141	$52.25	6
Pathology	180	140	$45.76	5
Orthopedic Surgery	133	104	$52.63	5
Osteopathic Manipulative Medicine	82	61	$48.49	3
Hand Surgery	53	51	$33.79	2

11900 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	26,135	$49.03	$31.92	669
Florida	17,302	$43.00	$30.88	562
New York	17,000	$52.18	$33.70	439
Texas	9,854	$42.08	$30.93	329
New Jersey	8,864	$49.17	$32.55	253
Illinois	5,954	$48.01	$33.43	184
Michigan	5,391	$44.72	$32.61	145
Pennsylvania	5,243	$45.77	$32.72	186
Virginia	4,657	$46.93	$32.83	152
Georgia	4,409	$43.69	$32.19	154
Arizona	4,369	$42.29	$30.88	171
Maryland	3,946	$50.78	$33.74	123
South Carolina	3,857	$40.25	$31.07	111
Tennessee	3,585	$39.30	$30.75	119
North Carolina	3,411	$41.24	$31.50	137
Massachusetts	3,377	$47.65	$32.01	131
Ohio	3,218	$41.71	$31.26	117
Washington	2,428	$44.67	$30.51	90
Louisiana	2,416	$42.23	$33.98	61
Colorado	2,183	$46.41	$31.84	85
Missouri	1,881	$41.57	$31.74	79
Indiana	1,869	$41.03	$31.11	76
Alabama	1,534	$38.44	$30.85	61
Wisconsin	1,516	$38.34	$28.52	59
Iowa	1,442	$38.94	$29.80	57
Connecticut	1,274	$50.69	$34.14	46
Kentucky	1,273	$41.49	$31.71	49
Nevada	1,143	$43.71	$31.35	39
Kansas	1,134	$38.78	$30.57	41
Minnesota	1,130	$43.11	$30.45	49
Oregon	1,067	$41.23	$29.22	47
Oklahoma	978	$37.56	$29.05	33
Mississippi	920	$40.01	$32.08	31
Arkansas	914	$36.49	$29.51	37
New Hampshire	797	$43.28	$30.05	32
Nebraska	793	$42.07	$31.99	31
Utah	639	$38.77	$29.80	29
Montana	590	$40.04	$28.21	23
South Dakota	503	$35.44	$26.90	18
Idaho	467	$35.75	$26.20	22
Delaware	451	$47.17	$33.04	16
Hawaii	422	$48.46	$32.58	18
West Virginia	372	$39.33	$30.90	17
Wyoming	366	$44.58	$30.93	14
District of Columbia	306	$58.80	$36.44	11
Rhode Island	295	$46.23	$31.88	15
New Mexico	283	$38.71	$27.76	9
Maine	186	$39.13	$28.55	10
North Dakota	162	$33.91	$25.39	9
Vermont	113	$40.56	$28.52	4
Alaska	110	$51.21	$31.53	5

Related codes

11901Injection into skin growth$62.69
11980Placement of hormone pellet under skin$85.14
11981Insertion of drug delivery implant into tissue$31.39

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.