CPT11104

Skin Biopsy (Punch) Cost in Tennessee

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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Tennessee Medicare physician rate (2026)

-8.0% vs national

Single statewide locality.

Tennessee (Hospital)
$35.96
Facility physician fee
Private plan est.
$145–$223
~130–200% of Medicare
Cash / self-pay est.
$89–$167
~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 Tennessee

Enter a ZIP code for your part of Tennessee, whether Nashville, Memphis, Knoxville, Chattanooga, the Tri-Cities, or the rural plateau and delta counties.

What skin biopsy (punch) costs at hospitals near you

Everything above is a national average. The hospital you pick in Tennessee 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.

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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 Tennessee the office and hospital physician lines for this CPT differ by $75.60.

National vs Tennessee

National office$121.25
National hospital (physician)$38.08
Tennessee vs national8% below the national office rate of $121.25

Where Tennessee ranks for this CPT

Rank (lowest physician fee first)#8 of 51
Lowest stateArkansas ($106.93)
Highest stateAlaska ($139.35)

Skin Biopsy (Punch) and how Tennessee is priced

Tennessee's Medicare rates come from one statewide locality with below-average geographic indices, so Memphis, Nashville, Knoxville, and Chattanooga all publish the same approved amounts despite being four distinct metro markets. The uniform locality stretches across a state that spans two time zones and several regional economies. Nashville's boom has raised local practice costs faster than the statewide averages that feed the indices. For patients, the fee schedule is identical statewide; the markets around it are anything but.

Nashville is the corporate capital of American hospital operations, home to major for-profit chains, alongside a prominent academic medical center, while Memphis anchors care for the Mid-South including parts of Mississippi and Arkansas. Knoxville and Chattanooga serve East Tennessee, and the rural Cumberland Plateau and West Tennessee counties have seen multiple hospital closures. Cross-border patient flows into Tennessee's metros are heavy from every neighboring state.

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 Tennessee: questions

Tennessee is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 11104 is $111.56 in an office and $35.96 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Tennessee 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 $22 for the office physician line or $7 for the hospital physician line in Tennessee. Medigap may cover that 20%. This is not the hospital facility fee.

No. $111.56 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. Tennessee ranks #8 of 51 states on the physician line (8% 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.