CPT11104

Skin Biopsy (Punch) Cost in North Carolina

Punch bx skin single lesion

$453Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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North Carolina Medicare physician rate (2026)

-5.9% vs national

Single statewide locality.

North Carolina (Hospital)
$36.45
Facility physician fee
Private plan est.
$148–$228
~130–200% of Medicare
Cash / self-pay est.
$91–$171
~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
$130
$38 physician + $92 facility
Physician fee alone
$38
Only 8% of the hospital total

Choosing a surgery centre 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 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 North Carolina

Check your ZIP code for your region of North Carolina, whether Charlotte, Raleigh-Durham and the Triangle, the Triad, Asheville and the mountains, or Wilmington and the coastal east.

What skin biopsy (punch) costs at hospitals near you

Everything above is a national average. The hospital you pick in North Carolina 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 North Carolina the office and hospital physician lines for this CPT differ by $77.60.

National vs North Carolina

National office$121.25
National hospital (physician)$38.08
North Carolina vs national6% below the national office rate of $121.25

Where North Carolina ranks for this CPT

Rank (lowest physician fee first)#17 of 51
Lowest stateArkansas ($106.93)
Highest stateAlaska ($139.35)

Skin Biopsy (Punch) and how North Carolina is priced

North Carolina's Medicare physician pricing comes from one statewide locality with indices just under the national average, so Charlotte, the Research Triangle, and the rural east and mountain west all share the same approved amounts. For a state with several fast-growing metros, the single-locality approach keeps the fee schedule simple even as local economies diverge. Nothing in the geographic adjustments distinguishes a Raleigh procedure from one in Boone or Greenville. As elsewhere, the office-versus-hospital setting decision moves prices more than geography within the state does.

North Carolina is unusually rich in academic medicine, with multiple nationally known university medical centers clustered in the Triangle and Winston-Salem, plus a major hospital system anchored in Charlotte that has grown across the Southeast. The rural east and the mountain counties are much thinner markets, and hospital consolidation has been reshaping who owns local care. Patients near the borders sometimes use Virginia or South Carolina providers.

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?

Skin Biopsy (Punch) in North Carolina: questions

North Carolina is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 11104 is $114.05 in an office and $36.45 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. North Carolina uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

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 North Carolina. Medigap may cover that 20%. This is not the hospital facility fee.

No. $114.05 is only the physician's share. Adding Medicare's facility payment brings the total to about $453 in a hospital outpatient department, or about $130 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. North Carolina ranks #17 of 51 states on the physician line (6% below the national office rate of $121.25).

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.