11105

Punch biopsy, each additional skin growth

Medicare pricing data for 18,008 providers across 52 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Punch biopsy, each additional skin growth (HCPCS code 11105) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $51.60, but hospitals typically charge $145.65 — a 2.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.32

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $51.60, your out-of-pocket cost would be approximately $10.32. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$51.60
Average Hospital Charge
$145.65
Markup Ratio
2.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$145.65
Medicare Allowed$51.60
Medicare Payment$40.36

Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $40.36 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$62$1594361,476+19.7%
Hawaii$61$12557169+17.6%
Puerto Rico$59$651012+14.6%
District of Columbia$59$15157281+14.0%
California$59$1581,5047,735+13.9%
Connecticut$58$200185634+13.4%
Wyoming$57$16340337+10.3%
New York$56$1819083,208+9.1%
Colorado$56$1363161,110+8.8%
Florida$55$1341,5399,130+7.4%
Alaska$55$25754114+7.0%
Maryland$55$1403842,004+6.6%
Nevada$54$168131522+5.4%
Virginia$54$1354792,206+4.3%
Rhode Island$53$12879229+3.2%
Illinois$52$1507183,689+1.3%
Texas$52$1441,0794,570+1.2%
Arizona$52$1364812,613+1.1%
Massachusetts$52$1775743,110-0.0%
Delaware$51$10962343-1.3%
Georgia$51$1444521,919-1.5%
Oregon$51$1502801,227-2.1%
Washington$50$1344642,033-2.3%
Michigan$50$1205121,580-2.4%
South Carolina$49$1233111,549-4.6%
Pennsylvania$49$1277412,280-5.9%
Kentucky$48$1272511,315-6.2%
Louisiana$48$120192563-7.0%
Tennessee$48$1114021,893-7.1%
New Mexico$48$114100330-7.5%
Mississippi$48$112143648-7.5%
Alabama$48$1092571,335-7.6%
North Carolina$48$1516843,011-7.7%
Missouri$47$1313621,338-8.1%
Utah$47$137199670-8.6%
Oklahoma$47$129181466-9.2%
Idaho$46$123130549-10.0%
Kansas$46$1342181,035-10.2%
Nebraska$46$139159565-10.2%
Ohio$46$1306441,997-11.7%
Indiana$45$1793722,401-12.1%
Minnesota$45$1904001,290-12.3%
Arkansas$45$95165584-12.7%
Montana$45$10894419-13.4%
New Hampshire$44$150106380-14.3%
West Virginia$44$132122611-14.4%
Iowa$44$1392601,042-15.6%
Maine$43$11991185-15.8%
Vermont$43$12939116-17.3%
Wisconsin$42$2523961,389-18.8%
South Dakota$37$11590300-27.8%
North Dakota$35$10482238-32.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber