Skin Biopsy (Punch) Cost in Rhode Island
Punch bx skin single lesion
$453Hospital 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
Rhode Island Medicare physician rate (2026)
+2.6% vs nationalSingle statewide locality.
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 $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 Rhode Island
Enter a ZIP code for your part of Rhode Island, whether Providence and Pawtucket, Warwick and Cranston, Newport, or the South County shore towns.
What skin biopsy (punch) costs at hospitals near you
Everything above is a national average. The hospital you pick in Rhode Island 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 Rhode Island the office and hospital physician lines for this CPT differ by $85.91.
National vs Rhode Island
Where Rhode Island ranks for this CPT
Skin Biopsy (Punch) and how Rhode Island is priced
Rhode Island, the smallest state, is unsurprisingly a single payment locality, with geographic adjustments above the national average in line with southern New England's cost structure. Providence and the shoreline towns publish identical Medicare-approved amounts, and no point in the state is more than an hour from its main hospitals. The compact geography makes locality subdivision pointless. Pricing here reads as a slightly discounted echo of neighboring Boston's market.
Providence dominates Rhode Island care, with the state's teaching hospitals and academic affiliation concentrated there, and consolidation has left a small number of systems running most beds. Many Rhode Islanders, particularly in the northeast corner, use Boston hospitals for complex or specialized procedures, accepting metro Boston pricing when they do. South County residents have fewer local options and often travel to Providence.
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 Rhode Island
Skin Biopsy (Punch) in other states
Skin Biopsy (Punch) in Rhode Island: questions
Rhode Island is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 11104 is $124.44 in an office and $38.53 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Rhode Island 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 $25 for the office physician line or $8 for the hospital physician line in Rhode Island. Medigap may cover that 20%. This is not the hospital facility fee.
No. $124.44 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. Rhode Island ranks #39 of 51 states on the physician line (3% above the national office rate of $121.25).