Skin Biopsy (Punch) Cost in Missouri
Punch bx skin single lesion
Missouri Medicare physician rate (2026)
-6.2% vs nationalAverage of 3 localities. Office range $108.58–$116.87.
Your ZIP in Missouri
Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
What this number is
The figures on this page are 2026 Medicare physician allowed amounts for a specific CPT code: the professional fee, adjusted by geographic practice-cost indices. They are not a hospital chargemaster price, not your insurer's contracted rate, and not a quote. Hospital facility fees, anesthesia, implants, imaging reads, and pathology are billed separately when they apply. In Missouri the office and hospital physician lines for this CPT differ by $76.32.
National vs Missouri
Where Missouri ranks for this CPT
CPT 11104 by Missouri locality
| Locality | Office |
|---|---|
| metropolitan st. louis | $116.87 |
| metropolitan kansas city | $115.61 |
| rest of missouri | $108.58 |
PE GPCI ranges from 0.862 to 0.952 in Missouri. That index is why the same CPT is not one price statewide.
Skin Biopsy (Punch) and how Missouri is priced
Missouri is a three-locality state: metropolitan St. Louis and metropolitan Kansas City are each priced separately, and everywhere else falls into a rest-of-state locality with lower geographic adjustments. Both metro localities approve higher amounts than outstate Missouri, and the Kansas City locality applies only to the Missouri side of that metro, since the Kansas side prices under Kansas's statewide locality. Springfield, Columbia, and the rural counties all share rest-of-state factors. The metro-versus-outstate gap is the main pricing story here.
St. Louis and Kansas City hold the state's academic medical centers and most of its specialty depth, drawing patients from far beyond Missouri's borders, including southern Illinois and eastern Kansas. Outstate Missouri is served by regional hubs in Springfield, Columbia, and Cape Girardeau, with the Ozarks and Bootheel among the harder places to reach specialty care. Rural hospital viability has been a persistent concern across the state.
This procedure: A punch biopsy uses a small round cutting tool, usually 2 to 6 millimeters across, to remove a full-thickness core of skin down through the deeper layers. Dermatologists choose it over a shave when they need to see the entire depth of the skin, for example to evaluate a rash, a suspected melanoma, or an inflammatory condition. After a numbing injection, the punch takes under a minute, and the small hole is typically closed with one or two stitches that come out in one to two weeks.
What Is Skin Biopsy (Punch)?
A punch biopsy uses a small round cutting tool, usually 2 to 6 millimeters across, to remove a full-thickness core of skin down through the deeper layers. Dermatologists choose it over a shave when they need to see the entire depth of the skin, for example to evaluate a rash, a suspected melanoma, or an inflammatory condition. After a numbing injection, the punch takes under a minute, and the small hole is typically closed with one or two stitches that come out in one to two weeks.
What Affects the Cost
- The separate pathology fee for processing and reading the full-thickness specimen is often the largest single charge on the bill.
- Additional punches at the same visit are billed with add-on code 11105 for each extra lesion.
- Because punch sites are usually sutured, a suture removal or wound check visit may generate its own charge if done as a distinct appointment.
- Rash workups sometimes require special immunofluorescence or extra stains at the lab, which increases the pathology bill.
- A biopsy done in a hospital-based clinic carries a facility fee on top of the physician charge.
Questions to Ask Before Booking
- 1.Why a punch rather than a shave biopsy, and does the choice change the cost?
- 2.Is my suture removal visit included, or billed separately?
- 3.Which lab reads the specimen and is it in network for my plan?
- 4.If special stains are needed for my rash, what extra lab charges should I expect?
- 5.How many sites do you plan to biopsy today, and what is the add-on charge per site?
Other featured procedures in Missouri
Skin Biopsy (Punch) in other states
Skin Biopsy (Punch) in Missouri: questions
How much does skin biopsy (punch) cost in Missouri?
The 2026 Medicare physician office rate for CPT 11104 averages $113.69 across 3 Missouri localities, from $108.58 in REST OF MISSOURI to $116.87 in METROPOLITAN ST. LOUIS. The hospital physician rate averages $37.37. Enter a ZIP for the exact locality.
Does the rate change inside Missouri?
Yes. CMS splits Missouri into 3 payment localities. For this CPT the office physician fee spans $8.29 from the lowest to highest locality. Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
What will a Medicare patient owe for the physician fee?
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $23 for the office physician line or $7 for the hospital physician line in Missouri. Medigap may cover that 20%. This is not the hospital facility fee.
Is this the full skin biopsy (punch) bill in Missouri?
No. $113.69 is the Medicare physician allowed amount for CPT 11104. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Missouri ranks #15 of 51 states on this physician line (6% below the national office rate of $121.25).