11103

Biopsy of related skin growth, each additional growth

Medicare pricing data for 23,176 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 1.4 million services annually. Even small pricing inefficiencies here affect millions of patients. 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

Biopsy of related skin growth, each additional growth (HCPCS code 11103) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $47.42, but hospitals typically charge $115.05 — a 2.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$9.48

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $47.42, your out-of-pocket cost would be approximately $9.48. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$47.42
Average Hospital Charge
$115.05
Markup Ratio
2.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$115.05
Medicare Allowed$47.42
Medicare Payment$36.88

Hospitals charge 2.4x more than what Medicare allows for this procedure. Medicare actually pays $36.88 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$56$239371,023+18.6%
New York$56$1521,51681,723+17.5%
New Jersey$54$13066350,577+14.1%
District of Columbia$54$106601,442+13.5%
California$54$1172,166138,940+12.9%
Hawaii$52$121752,961+10.2%
Connecticut$52$13129914,670+9.2%
Maryland$51$11844422,559+8.5%
Massachusetts$50$16075236,287+6.1%
Puerto Rico$50$69551,041+5.2%
Colorado$49$11545119,600+3.0%
Delaware$49$89625,174+2.8%
Virginia$48$10858335,439+1.9%
Illinois$48$13179742,139+0.7%
Florida$47$982,224296,284+0.1%
Rhode Island$47$1211054,032-0.3%
Washington$47$12152321,629-1.0%
Nevada$47$1071559,553-1.5%
Texas$47$1131,48385,931-1.8%
Wyoming$47$126512,409-1.9%
Pennsylvania$46$1061,01559,456-2.8%
Arizona$46$10757750,302-2.9%
Oregon$46$13633512,822-3.4%
Michigan$45$10866221,344-4.5%
Maine$45$1211124,733-4.9%
Missouri$45$14638720,496-5.0%
Georgia$45$11962752,948-6.1%
North Carolina$44$11181546,954-6.3%
New Hampshire$44$1491265,750-6.6%
Louisiana$44$9927910,434-7.2%
Utah$43$1052668,869-8.3%
Montana$43$1011095,605-8.3%
South Carolina$43$10135530,138-8.8%
Ohio$43$11178129,372-9.0%
Kentucky$43$9327316,962-9.3%
Minnesota$43$15447915,300-9.4%
Indiana$43$12143018,789-9.6%
Oklahoma$43$1102029,730-10.0%
Alabama$43$10533423,108-10.1%
Tennessee$43$9847938,005-10.2%
New Mexico$43$119985,882-10.3%
Kansas$42$10521010,760-10.7%
Mississippi$42$8715510,197-12.0%
Nebraska$41$1231646,098-14.0%
Iowa$40$1342608,842-14.7%
Arkansas$40$8118410,513-15.1%
Idaho$39$921555,502-17.2%
West Virginia$39$1091185,290-17.8%
Wisconsin$39$19443014,191-18.7%
Vermont$38$99551,868-19.0%
South Dakota$37$1041067,302-22.6%
North Dakota$30$78762,233-37.6%

⚠️ 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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