CPT 11104 Surgery - Integumentary

How Much Does Skin Biopsy (Punch) Cost?

Also known as: Punch bx skin single lesion (CPT 11104)

A punch biopsy of the skin, where a small, circular tool removes a deeper sample of skin tissue.

The total estimated cost of Skin Biopsy (Punch) (CPT 11104) is $91 to $149, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $38.

Total Estimated Cost of Care

$91 — $149

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$38
Hospital Facility Fee
$76
Important: The physician fee of $38 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$38
Physician component only — CMS PFS 2026
Medicare Physician Fee (Office/Clinic)
$121
Non-facility setting

Patient Guide: Skin Biopsy (Punch)

What you need to know before your appointment

What to Expect

The doctor numbs the area and uses a small circular blade (like a tiny cookie cutter) to remove a round piece of skin including deeper layers. One or two stitches may be needed to close the site.

How Long Does It Take?

10-15 minutes

Common Reasons Doctors Order This

Rash diagnosis, suspected skin cancer, inflammatory skin conditions, deeper skin lesion evaluation

How to Prepare

No special preparation. The area will be numbed. Inform your doctor about blood thinners. Stitches may need removal in 7-14 days.

Procedures Commonly Done Together

These procedures are frequently performed alongside Punch bx skin single lesion

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How to Reduce Your Cost for Punch bx skin single lesion

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($121) differs from the facility rate ($38). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

0.81
Work RVU
0.24
Practice Expense RVU
0.09
Malpractice RVU
3.63
Total RVU

Payment = Total RVU (3.63) x CF ($33.40) = $121

Frequently Asked Questions

How much does Punch bx skin single lesion cost?

The Medicare facility rate for Punch bx skin single lesion is $38. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Punch bx skin single lesion cost without insurance?

Without insurance, the cost of Punch bx skin single lesion can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Punch bx skin single lesion?

Most commercial health insurance plans and Medicare cover Punch bx skin single lesion when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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