CPT11104

How Much Does a Skin Biopsy (Punch) Cost in North Dakota?

Punch bx skin single lesion

$119.46In-office total2026 Medicare, North Dakota average

Under 2026 Medicare rates, a skin biopsy (punch) in a doctor's office costs about $119 in North Dakota, 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.

Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers. For example 58001.
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North Dakota Medicare physician rate (2026)

-1.5% vs national

Single statewide locality.

North Dakota (Hospital)
$36.29
Facility physician fee
Private plan est.
$155–$239
~130–200% of Medicare
Cash / self-pay est.
$96–$179
~80–150% of Medicare

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.

Surgery center, total
$130
$38 physician + $92 facility
Physician fee alone
$38
Only 8% of the hospital total

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 North Dakota

Enter a ZIP code for your part of North Dakota, whether Fargo, Bismarck, Grand Forks, Minot, or the farm and oil country in between.

What skin biopsy (punch) costs at hospitals near you

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

Locked

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

For example 58001.

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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 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 North Dakota the office and hospital physician lines for this CPT differ by $83.17.

National vs North Dakota

National office$121.25
National hospital (physician)$38.08
North Dakota vs nationalwithin 2% of the national office rate of $121.25

Where North Dakota ranks for this CPT

Rank (lowest physician fee first)#28 of 51
Lowest stateArkansas ($106.93)
Highest stateAlaska ($139.35)

Skin Biopsy (Punch) and how North Dakota is priced

North Dakota's entire fee schedule flows through one statewide locality whose geographic indices sit near the national floor, lifted partly by the work index floor CMS applies to low-cost states. Fargo and a prairie town on the Canadian border publish identical Medicare-approved amounts. With no metro large enough to justify its own locality, the state is among the most straightforward in the country for Medicare pricing. Oil-patch growth in the west changed local economies but not the fee schedule structure.

Fargo and Bismarck are the state's two care anchors, each dominated by large regional systems that also reach into Minnesota, South Dakota, and Montana, with Grand Forks and Minot serving their own areas. Much of rural North Dakota depends on critical access hospitals, and winter travel adds a genuine planning constraint. Some eastern residents cross into Minnesota for care, particularly toward Fargo-Moorhead's twin market.

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 Dakota: questions

Under 2026 Medicare rates, a skin biopsy (punch) in a doctor's office costs about $119 in North Dakota, 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. North Dakota is a single Medicare locality, so the physician rate is the same statewide.

Not on the physician fee schedule. North Dakota 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 $24 for the office physician line or $7 for the hospital physician line in North Dakota. Medigap may cover that 20%. This is not the hospital facility fee.

In a doctor's office, $119.46 is Medicare's whole payment in North Dakota: 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 $36.29 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. North Dakota ranks #28 of 51 states on the office rate (within 2% of 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.