How Much Does a Skin Biopsy (Punch) Cost in Virginia?
Punch bx skin single lesion
$118.81In-office total2026 Medicare, Virginia averageUnder 2026 Medicare rates, a skin biopsy (punch) in a doctor's office costs about $119 in Virginia, 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.
- ✓Your ZIP's wage-adjusted hospital and surgery center 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
Virginia Medicare physician rate (2026)
-2.0% vs nationalSingle statewide locality.
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.
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 Virginia
Check your exact ZIP in Virginia, because Arlington and Alexandria price with Washington while Richmond, Virginia Beach and Hampton Roads, Charlottesville, Roanoke, and the rural southwest do not.
What skin biopsy (punch) costs at hospitals near you
Everything above is a national average. The hospital you pick in Virginia 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.
For example 00303.
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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 Virginia the office and hospital physician lines for this CPT differ by $81.75.
National vs Virginia
Where Virginia ranks for this CPT
Skin Biopsy (Punch) and how Virginia is priced
Virginia's physician fees are set through a small number of Medicare payment localities rather than one statewide rate, and the picture is complicated further by the DC locality reaching across the Potomac to cover close-in Northern Virginia suburbs like Arlington and Alexandria at the region's highest adjustments. The rest of the commonwealth, including Richmond, Hampton Roads, and the rural south and west, prices at lower levels through Virginia's own localities. That makes the Northern Virginia line one of the sharper pricing boundaries on the East Coast. Where exactly you sit relative to it is worth confirming.
Virginia's care landscape is regionally distinct: Northern Virginia operates as part of the Washington market, Richmond hosts an academic medical center and large system headquarters, Hampton Roads supports its own dense hospital market, and university medicine anchors Charlottesville. Southwest Virginia's coalfield counties face some of the state's toughest access problems, with some residents using Tennessee providers. Military health facilities add another layer in the Tidewater region.
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 Virginia
Skin Biopsy (Punch) in other states
Skin Biopsy (Punch) in Virginia: questions
Under 2026 Medicare rates, a skin biopsy (punch) in a doctor's office costs about $119 in Virginia, 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. Virginia is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. Virginia 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 Virginia. Medigap may cover that 20%. This is not the hospital facility fee.
In a doctor's office, $118.81 is Medicare's whole payment in Virginia: 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 $37.06 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. Virginia ranks #25 of 51 states on the office rate (2% below the national office rate of $121.25).