How Much Does a Skin Biopsy (Punch) Cost in New Jersey?
Punch bx skin single lesion
$134.38In-office total2026 Medicare, New Jersey averageUnder 2026 Medicare rates, a skin biopsy (punch) in a doctor's office costs about $134 in New Jersey, from $131 in Rest of New Jersey to $138 in Northern Nj, with no separate facility fee. In a facility the national total is about $453 at a hospital outpatient department or about $130 at an ambulatory surgery center, because the facility is paid its own rate on top of the physician.
- ✓Your ZIP's wage-adjusted hospital and surgery center 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
New Jersey Medicare physician rate (2026)
+10.8% vs nationalAverage of 2 localities. Office range $131.01–$137.74.
What it costs in a hospital or surgery center
In a doctor’s office, the office rate above is the whole Medicare payment. When the same procedure is done in a hospital or surgery center, the facility bills its own fee on top of the physician, which is what these totals show. They are 2026 national Medicare amounts.
Choosing a surgery center over a hospital saves about $324 on the Medicare allowed amount for skin biopsy (punch). Ask whether your procedure can be done at an ambulatory surgery center.
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 New Jersey
Look up your ZIP code to see whether northern or rest-of-state New Jersey pricing applies, from Newark, Jersey City, and Bergen County down to Trenton, Cherry Hill, and the Jersey Shore.
What skin biopsy (punch) costs at hospitals near you
Everything above is a national average. The hospital you pick in New Jersey 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.
For example 07001.
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 center 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 New Jersey the office and hospital physician lines for this CPT differ by $93.65.
National vs New Jersey
Where New Jersey ranks for this CPT
CPT 11104 by New Jersey locality
| Locality | Office |
|---|---|
| northern nj | $137.74 |
| rest of new jersey | $131.01 |
PE GPCI ranges from 1.092 to 1.160 in New Jersey. That index is why the same CPT is not one price statewide.
Skin Biopsy (Punch) and how New Jersey is priced
New Jersey is split into two payment localities: northern New Jersey, which carries higher adjustments befitting its position in the New York metropolitan orbit, and the rest of the state to the south. Both localities price above the national average, but the northern one ranks among the more expensive in the country. The dividing line means a procedure in Bergen County is approved at a higher amount than the same one in Cherry Hill or along the shore. South Jersey's pricing gravity pulls toward Philadelphia even though its locality is its own.
New Jersey may be the ultimate cross-border care state: North Jersey residents flow into Manhattan hospitals, South Jersey residents into Philadelphia's academic centers, and the state's own large systems compete hard in between. Dense population means most residents have multiple hospitals within a short drive, which is real negotiating leverage for a cash-pay patient. The shore counties see seasonal population surges that strain capacity each summer.
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 New Jersey
Skin Biopsy (Punch) in other states
Skin Biopsy (Punch) in New Jersey: questions
Under 2026 Medicare rates, a skin biopsy (punch) in a doctor's office costs about $134 in New Jersey, from $131 in Rest of New Jersey to $138 in Northern Nj, with no separate facility fee. In a facility the national total is about $453 at a hospital outpatient department or about $130 at an ambulatory surgery center, because the facility is paid its own rate on top of the physician. Enter a ZIP for the exact New Jersey locality.
Yes. CMS splits New Jersey into 2 payment localities. For this CPT the office physician fee spans $6.73 from the lowest to highest locality. Look up your ZIP code to see whether northern or rest-of-state New Jersey pricing applies, from Newark, Jersey City, and Bergen County down to Trenton, Cherry Hill, and the Jersey Shore.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $27 for the office physician line or $8 for the hospital physician line in New Jersey. Medigap may cover that 20%. This is not the hospital facility fee.
In a doctor's office, $134.38 is Medicare's whole payment in New Jersey: it covers the physician, the room and the supplies, with no separate facility fee. If it is done in a hospital outpatient department instead, the physician is paid about $40.73 and the hospital adds its own facility payment, bringing the national total to about $453. Services billed under other codes, such as lab work, are extra. New Jersey ranks #48 of 51 states on the office rate (11% above the national office rate of $121.25).