Skin Biopsy (Tangential) Cost in Pennsylvania
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$445Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre 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
Pennsylvania Medicare physician rate (2026)
-1.2% vs nationalAverage of 2 localities. Office range $89.50–$99.26.
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.
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 Pennsylvania
Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
What skin biopsy (tangential) costs at hospitals near you
Everything above is a national average. The hospital you pick in Pennsylvania 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.
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 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 Pennsylvania the office and hospital physician lines for this CPT differ by $64.12.
National vs Pennsylvania
Where Pennsylvania ranks for this CPT
CPT 11102 by Pennsylvania locality
| Locality | Office |
|---|---|
| metropolitan philadelphia | $99.26 |
| rest of pennsylvania | $89.50 |
PE GPCI ranges from 0.918 to 1.041 in Pennsylvania. That index is why the same CPT is not one price statewide.
Skin Biopsy (Tangential) and how Pennsylvania is priced
Pennsylvania's fee schedule separates metro Philadelphia from the rest of the state, giving the southeast its own higher-cost locality while Pittsburgh, Harrisburg, Allentown, Erie, and rural Pennsylvania share rest-of-state adjustments. That means the state's second-largest medical market, Pittsburgh, is priced with rural counties rather than with Philadelphia. The Philadelphia locality's premium reflects the metro's wage and rent levels, which lead the state by a wide margin. For patients, the key locality question in Pennsylvania is simply whether care happens in the Philadelphia area.
Philadelphia is one of America's historic centers of academic medicine, dense with teaching hospitals, while Pittsburgh is dominated by a pair of large integrated systems whose rivalry has defined that market for years. The rural middle of the state, sometimes called the T, has far fewer options, and hospital closures there have drawn statewide attention. Residents near the edges use New York, Baltimore, or Ohio providers when convenient.
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?
Other featured procedures in Pennsylvania
Skin Biopsy (Tangential) in other states
Skin Biopsy (Tangential) in Pennsylvania: questions
The 2026 Medicare physician office rate for CPT 11102 averages $94.38 across 2 Pennsylvania localities, from $89.50 in REST OF PENNSYLVANIA to $99.26 in METROPOLITAN PHILADELPHIA. The hospital physician rate averages $30.26. Enter a ZIP for the exact locality.
Yes. CMS splits Pennsylvania into 2 payment localities. For this CPT the office physician fee spans $9.76 from the lowest to highest locality. Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $19 for the office physician line or $6 for the hospital physician line in Pennsylvania. Medigap may cover that 20%. This is not the hospital facility fee.
No. $94.38 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. Pennsylvania ranks #29 of 51 states on the physician line (within 2% of the national office rate of $95.53).