Skin Biopsy (Tangential) Cost
Tangntl bx skin single les
$445Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
National Medicare physician rate (2026)
What the whole procedure costs
The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.
Choosing a surgery centre over a hospital saves about $343 on the Medicare allowed amount for skin biopsy (tangential). Ask whether your procedure can be done at an ambulatory surgery centre.
This is Medicare's separate payment to the facility on top of the physician's fee. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Get the rate for your ZIP
CMS adjusts this CPT by locality. A five-digit ZIP is enough — no account, no insurance card.
What skin biopsy (tangential) costs at hospitals near you
Everything above is a national average. The hospital you pick in your area moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. For this code the office and hospital physician lines differ by $65.47.
How CMS prices CPT 11102
Work is about 22% of the office total RVU; practice expense is about 76%. Localities with a high PE GPCI move this code more when practice expense is a large share.
Office vs hospital for this code
Office (non-facility) physician rate: $95.53. Hospital (facility) physician rate: $30.06.
Medicare patients typically owe 20% of the allowed amount after the Part B deductible — about $19 for the office physician fee, before any Medigap coverage. That coinsurance does not include a hospital facility fee.
Labeled private-plan and cash ranges on this page are arithmetic multiples of Medicare, not negotiated quotes. Ask the billing office for the CPT code, the site of service, and a good-faith estimate.
What Is Skin Biopsy (Tangential)?
A tangential skin biopsy removes a thin shaving from the surface of a suspicious spot using a flexible blade, without cutting deep into the skin. It is the go-to technique when a dermatologist wants to test a raised or scaly lesion for skin cancer or another skin condition. The area is numbed with a small injection, the shave itself takes seconds, and no stitches are needed; the site heals like a scrape over one to two weeks.
What Affects the Cost
- –The pathologist who examines the tissue under a microscope bills a separate professional fee, and that charge often exceeds the biopsy itself.
- –Each additional lesion shaved at the same visit is billed with an add-on code (11103), so multiple spots multiply the cost.
- –If the shave visit also includes a full skin exam, an office visit charge is typically billed alongside the biopsy.
- –Special pathology stains or a second dermatopathologist opinion on an ambiguous mole add further lab charges.
- –Hospital-owned dermatology clinics can add a facility fee that a private dermatology office would not charge.
How It Is Billed
CPT 11102 pays for shaving the first lesion only; the laboratory work is always billed separately by the pathology lab under its own codes, frequently by a lab you have never heard of. If the doctor biopsies more than one spot, add-on code 11103 appears once per extra lesion. An evaluation and management charge for the visit is common when the biopsy decision was made the same day, so expect two or three line items from what felt like one quick appointment.
Insurance & Coverage Notes
Biopsy of a suspicious lesion is considered diagnostic and medically necessary, so it is covered by essentially all plans, but it is not preventive care, meaning your deductible and coinsurance apply even if the result comes back benign. Watch for the pathology claim: if the lab is out of network, the No Surprises Act generally protects you at in-network facilities, but confirming network status up front avoids disputes. Removal of a spot for purely cosmetic reasons is not covered at all.
Questions to Ask Before Booking
- 1.Which pathology lab will read my biopsy, and is it in my insurance network?
- 2.Roughly what does the pathology reading cost in addition to the biopsy fee?
- 3.If you biopsy more than one spot today, how does that change my bill?
- 4.Will today's skin check be billed as a separate office visit on top of the biopsy?
- 5.Is this being coded as medically necessary rather than cosmetic?
Skin Biopsy (Tangential) (CPT 11102): questions
The 2026 national Medicare physician rate for CPT 11102 is $95.53 in an office and $30.06 in a hospital. Enter a ZIP code to apply the geographic adjustment for your locality.
Medicare uses a different practice-expense RVU in a facility. For CPT 11102 that produces an office rate of $95.53 and a hospital physician rate of $30.06 (a $65.47 gap). The hospital’s own facility charge is extra and often larger than this entire physician line.
A tangential skin biopsy removes a thin shaving from the surface of a suspicious spot using a flexible blade, without cutting deep into the skin. It is the go-to technique when a dermatologist wants to test a raised or scaly lesion for skin cancer or another skin condition. The area is numbed with a small injection, the shave itself takes seconds, and no stitches are needed; the site heals like a scrape over one to two weeks. CMS bills it as “Tangntl bx skin single les.”
Not on its own. $95.53 is the physician allowed amount. Medicare also pays the facility, which takes the total to about $445 in a hospital outpatient department or about $103 at an ambulatory surgery centre. Anesthesia, pathology and imaging interpretation billed under other codes are separate again. Private-plan allowed amounts are often higher than Medicare; your deductible and coinsurance still apply.
For cash-pay surgery shopping, use this CPT as the Medicare floor when you compare written quotes. How cash-price shopping works.