CPT11102

Skin Biopsy (Tangential) Cost in Massachusetts

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$445Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Massachusetts Medicare physician rate (2026)

+9.6% vs national

Average of 2 localities. Office range $99.29–$110.18.

Massachusetts (Hospital)
$31.18
Facility physician fee
Private plan est.
$136–$209
~130–200% of Medicare
Cash / self-pay est.
$84–$157
~80–150% of Medicare

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.

Surgery centre, total
$103
$30 physician + $73 facility
Physician fee alone
$30
Only 7% of the hospital total

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.

Your ZIP in Massachusetts

Look up your ZIP to see whether metro Boston or rest-of-state pricing applies, from Boston and Cambridge to Worcester, Springfield, the North and South Shores, and Cape Cod.

What skin biopsy (tangential) costs at hospitals near you

Everything above is a national average. The hospital you pick in Massachusetts moves the bill more than anything else you control.

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Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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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. In Massachusetts the office and hospital physician lines for this CPT differ by $73.56.

National vs Massachusetts

National office$95.53
National hospital (physician)$30.06
Massachusetts vs national10% above the national office rate of $95.53

Where Massachusetts ranks for this CPT

Rank (lowest physician fee first)#45 of 51
Lowest stateArkansas ($84.38)
Highest stateAlaska ($110.00)

CPT 11102 by Massachusetts locality

LocalityOffice
metropolitan boston$110.18
rest of massachusetts$99.29

PE GPCI ranges from 1.053 to 1.194 in Massachusetts. That index is why the same CPT is not one price statewide.

Skin Biopsy (Tangential) and how Massachusetts is priced

Massachusetts is priced through two localities: metro Boston and the rest of the state. Boston's locality carries clearly higher geographic adjustments, reflecting some of the highest medical wages and office costs in the nation, while Worcester, Springfield, and the Cape share the lower rest-of-state factors. The split means the fee schedule itself acknowledges what everyone in the state already knows about Boston prices. Even so, rest-of-state Massachusetts still prices above most of the country.

Boston has arguably the densest concentration of academic medical centers anywhere, and its teaching hospitals pull referrals from all of New England and beyond. That prestige comes with a high-cost market structure that state policymakers have scrutinized for years. Western Massachusetts operates more like a regional market centered on Springfield, and Cape and islands residents contend with seasonal capacity strain.

This procedure: 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 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.

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) in Massachusetts: questions

The 2026 Medicare physician office rate for CPT 11102 averages $104.74 across 2 Massachusetts localities, from $99.29 in REST OF MASSACHUSETTS to $110.18 in METROPOLITAN BOSTON. The hospital physician rate averages $31.18. Enter a ZIP for the exact locality.

Yes. CMS splits Massachusetts into 2 payment localities. For this CPT the office physician fee spans $10.89 from the lowest to highest locality. Look up your ZIP to see whether metro Boston or rest-of-state pricing applies, from Boston and Cambridge to Worcester, Springfield, the North and South Shores, and Cape Cod.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $21 for the office physician line or $6 for the hospital physician line in Massachusetts. Medigap may cover that 20%. This is not the hospital facility fee.

No. $104.74 is only the physician's share. Adding Medicare's facility payment brings the total to about $445 in a hospital outpatient department, or about $103 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. Massachusetts ranks #45 of 51 states on the physician line (10% above the national office rate of $95.53).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.