How much does Medicare pay for CPT 17315?

Medicare allowed an average of $74.20 per service and paid $59.18 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $189.08, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 17315?

Removal and microscopic exam of growth, each additional block after 5 tissue blocks. It was billed 12,489 times to 3,466 Medicare beneficiaries by 106 providers in 2024.

Does 17315 pay differently in an office than a hospital?

Yes. The allowed amount averaged $76.21 in an office setting and $49.43 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 17315 most?

Dermatology, with 10,084 services from 77 clinicians. Next are Micrographic Dermatologic Surgery, Internal Medicine.

CPT 17315

Removal and microscopic exam of growth, each additional block after 5 tissue blocks

$74.20Medicare-allowed amount per service, averaged across 12,489 services

Providers submitted

$189.08

Asking price, not received

Medicare allowed

$74.20

The fee schedule figure

Medicare paid

$59.18

Balance is patient coinsurance

Providers submitted an average of $189.08 for this code and Medicare allowed $74.20 — 2.5× 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 $59.18 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $76.21
Hospital / facility: $49.43

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. 11,548 services were billed in an office setting and 941 in a facility.

Services: 12,489
Beneficiaries: 3,466
Providers billing it: 106
Total allowed: $926,684

What Medicare pays for CPT 17315

Across 12,489 services billed by 106 providers to 3,466 beneficiaries, Medicare allowed an average of $74.20 per service. That is 3.6 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 17315

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	10,084	2,681	$74.76	77
Micrographic Dermatologic Surgery	2,340	769	$71.65	28
Internal Medicine	65	16	$78.49	1

17315 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	4,795	$76.59	$62.52	10
Pennsylvania	1,297	$62.70	$51.59	15
California	976	$83.87	$60.97	15
Delaware	784	$77.76	$62.54	2
Tennessee	646	$73.58	$62.62	5
Georgia	550	$75.17	$62.79	6
Virginia	513	$63.51	$51.68	6
Texas	455	$77.67	$62.70	6
New York	436	$78.91	$58.73	6
New Jersey	250	$80.87	$62.44	3
Maryland	230	$83.17	$62.52	2
Rhode Island	211	$52.96	$40.39	2
North Carolina	208	$75.39	$62.49	4
Arkansas	151	$72.94	$62.57	2
Minnesota	150	$58.42	$46.69	3
Oregon	112	$57.63	$43.40	2
South Carolina	97	$73.11	$62.24	2
Missouri	93	$64.91	$55.88	3
Kentucky	80	$73.06	$62.45	1
Colorado	74	$82.91	$62.19	1
Michigan	73	$50.38	$38.58	1
Massachusetts	67	$81.28	$62.56	1
Arizona	67	$76.79	$62.25	1
Ohio	64	$74.17	$62.22	2
Washington	46	$82.42	$62.81	2
Kansas	23	$47.10	$38.54	1
New Hampshire	21	$79.04	$61.95	1
Montana	20	$47.60	$38.41	1

Related codes

17311Removal and microscopic exam of growth of head$569.13
17312Removal and microscopic exam of growth of head$398.30
17313Removal and microscopic exam of growth of trunk$572.12
17314Removal and microscopic exam of growth of trunk$395.35
17360Chemical treatment of acne$123.75

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.