11104

Punch biopsy, first skin growth

Medicare pricing data for 44,518 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, first skin growth (HCPCS code 11104) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $108.51, but hospitals typically charge $283.29 — a 2.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$21.70

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $108.51, your out-of-pocket cost would be approximately $21.70. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$108.51
Average Hospital Charge
$283.29
Markup Ratio
2.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$283.29
Medicare Allowed$108.51
Medicare Payment$79.53

Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $79.53 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$130$3201,0046,126+19.6%
California$127$3093,56128,708+17.0%
District of Columbia$123$284102642+13.5%
Puerto Rico$123$13447140+13.1%
Maryland$122$2887836,757+12.7%
Alaska$122$536192666+12.5%
Hawaii$121$247138721+11.5%
New York$120$3342,17512,672+10.6%
Colorado$120$2878584,665+10.2%
Connecticut$118$3354842,111+9.1%
Wyoming$115$303127806+6.2%
Virginia$114$2521,2058,666+4.9%
Nevada$114$2802661,835+4.7%
Florida$113$2533,30730,409+4.6%
Rhode Island$113$268155813+3.9%
Delaware$112$2191601,530+3.1%
Massachusetts$112$3631,2069,381+2.9%
Illinois$111$3051,60313,131+2.4%
Arizona$110$2789817,029+1.0%
Georgia$108$2871,0927,457-0.5%
Oregon$108$3187774,944-0.7%
Texas$108$2822,61316,180-0.8%
Washington$108$2791,2347,739-0.9%
Michigan$105$2401,4927,037-3.4%
Pennsylvania$105$2421,97610,782-3.4%
North Carolina$104$2731,66610,104-4.4%
South Carolina$104$2407515,714-4.5%
Louisiana$102$2425403,763-5.7%
Tennessee$101$2311,0507,899-7.1%
Mississippi$100$2313672,776-7.5%
Utah$100$2625012,556-7.9%
Alabama$100$2246214,263-7.9%
Kentucky$100$2206254,863-8.1%
Missouri$100$2678915,237-8.1%
Kansas$99$2665874,270-8.7%
Oklahoma$99$2455863,013-9.1%
New Mexico$98$2703031,362-9.7%
Ohio$98$2431,6788,606-9.8%
Nebraska$98$2904742,318-10.0%
New Hampshire$96$3102941,737-11.6%
Arkansas$95$2014352,909-12.2%
Idaho$95$2193612,105-12.2%
Minnesota$94$3681,0484,859-13.4%
Montana$93$2332532,009-14.6%
Indiana$92$3381,0418,157-15.2%
West Virginia$92$2572502,513-15.3%
Iowa$92$3047244,546-15.4%
Wisconsin$89$4871,0235,313-17.6%
Maine$87$239284962-20.2%
Vermont$85$224125652-21.4%
North Dakota$75$2322211,126-31.0%
South Dakota$71$2492451,333-34.1%

⚠️ 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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