CPT code 11104: Punch biopsy, single skin lesion2026 Medicare rate & RVUs in Mississippi

A punch biopsy removes a cylindrical skin sample from one lesion for diagnostic examination when a core specimen is needed.

CMS RVU26DEffective Oct 1, 2026One payment locality286.1K Medicare services in 2024

In Mississippi, Medicare pays $107.79 for 11104 in the office and $36.18 when it’s performed in a hospital or facility.

$107.79Office (non-facility)
$36.18Hospital or facility
−11.1%vs the national office rate ($121.25)

Check a contract rate as a % of Medicare · 11104 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 11104 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Mississippi
  2. What 11104 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 11104 covers

A punch biopsy uses a circular cutting instrument to obtain a cylindrical sample of skin from one lesion for diagnostic evaluation. Dermatologists and other clinicians may perform it in an office or facility setting, commonly when evaluating a suspicious growth or a skin condition that requires tissue examination. Simple closure, when performed, is included in the procedure.

Choose this code for one lesion sampled by the punch technique; the method, rather than the lesion’s diagnosis or size, distinguishes it from tangential or incisional biopsy codes. For additional separate lesions sampled by punch during the same session, report 11105. Document the sampled site, punch technique, number of lesions, and reason for the biopsy. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, CMS pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate; assistant-at-surgery services are not paid, and co-surgeon and team-surgery billing are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Mississippi compares for 11104

Across 109 of 109 payment localities, the office rate for 11104 runs from $106.93 in Arkansas to $163.13 in San Benito County, CA. Mississippi pays $107.79. The RVUs are the same everywhere; the geographic indexes change the dollars.

11104 in Mississippi vs other payment areas
  1. Mississippi · this page$107.79
  2. Los Angeles, CA · California$138.03+$30.24
  3. Washington, DC area · District of Columbia$139.28+$31.49
  4. Miami, FL · Florida$129.58+$21.79
  5. Chicago, IL · Illinois$125.78+$17.99
  6. Manhattan, NY · New York$139.51+$31.72
  7. Alaska · Alaska$139.35+$31.56

Other areas in Mississippi first, then benchmark localities. Bars start at $0.

Every other payment area

11104 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$108.54$35.77
ArkansasArkansas$106.93$35.49
ArizonaArizona$117.99$37.40
Bakersfield, CACalifornia$129.34$38.19
Chico, CACalifornia$129.06$37.91
El Centro, CACalifornia$129.08$37.93
Fresno, CACalifornia$129.06$37.91
Hanford, CACalifornia$129.06$37.91

11104 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$106.93

$146.10

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
11104 office rate range by state
State / territoryOffice rate rangeLocalities
AK$139.351
AL$108.541
AR$106.931
AZ$117.991
CA$129.06–$163.1329
CO$126.751
CT$129.441
DC$139.281
DE$119.981
FL$118.75–$129.583
GA$111.97–$123.392
GU$132.471
HI$132.471
IA$111.681
ID$112.371
IL$115.00–$126.224
IN$113.041
KS$111.001
KY$110.871
LA$110.63–$116.272
MA$125.90–$139.712
MD$122.36–$139.283
ME$112.81–$119.322
MI$113.70–$120.122
MN$121.771
MO$108.58–$116.873
MS$107.791
MT$121.241
NC$114.051
ND$119.461
NE$112.351
NH$124.611
NJ$131.01–$137.742
NM$114.281
NV$120.831
NY$115.79–$142.795
OH$113.341
OK$110.821
OR$119.99–$131.032
PA$113.60–$126.052
PR$122.201
RI$124.441
SC$113.861
SD$119.251
TN$111.561
TX$112.83–$126.258
UT$115.471
VA$118.81–$139.282
VI$122.201
VT$118.851
WA$125.71–$142.752
WI$115.341
WV$110.601
WY$120.461

See 11104 in every payment locality

How the 11104 rate is calculated

Each of 11104’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 11104

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.81

0.81 RVUs× 1.000 GPCI

Practice expense2.73

2.73 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

3.6300

Conversion factor

$33.4009

Medicare rate

$121.25

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Mississippi inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,272

Code
11104
Physician work
0.81
Practice expense
2.73
Malpractice
0.09

GPCI2026.csv

67

Locality
Mississippi
Physician work
1.000
Practice expense
0.861
Malpractice
0.739
Office calculation for 11104 in Mississippi
ComponentRVULocality factorAdjusted
Physician work0.81× 1.0000.8100
Practice expense2.73× 0.8612.3505
Malpractice0.09× 0.7390.0665
Total RVUs3.2270
Conversion factor× 33.4009

Office rate, Mississippi$107.79

Office: (0.81 × 1 + 2.73 × 0.861 + 0.09 × 0.739) × $33.4009 = $107.79

Facility: (0.81 × 1 + 0.24 × 0.861 + 0.09 × 0.739) × $33.4009 = $36.18

Open 11104 in the RVU calculator

Payment rules and modifiers for 11104

The CMS indicators that decide how 11104 is paid alongside other services.

CMS payment indicators · 11104

Punch biopsy, single skin lesion

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

11104 without 51 · national office

$121.25

Punch biopsy, single skin lesion

11104-51 · Second procedure: 50%

$60.63

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 11104 has changed in Mississippi

11104 · Office / nonfacility

$107.79

Effective 2026-10-01

The base rate is $2.39 higher than on 2025-10-01, moving from $105.40 to $107.79 (2.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $105.40changed to$107.79

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.83 changed to 0.81
    • Practice expense RVU 2.76 changed to 2.73
    • Malpractice RVU 0.10 changed to 0.09
    • Practice expense GPCI 0.852 changed to 0.861
    • Malpractice GPCI 0.768 changed to 0.739

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $110.45changed to$105.40

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.83 changed to 2.76

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $108.64changed to$110.45

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $112.37changed to$108.64

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.85 changed to 2.83
    • Practice expense GPCI 0.847 changed to 0.852
    • Malpractice GPCI 0.720 changed to 0.768
  5. January 1, 2023

    RVU23A

    $114.44changed to$112.37

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.87 changed to 2.85
    • Malpractice RVU 0.09 changed to 0.10
    • Practice expense GPCI 0.842 changed to 0.847
    • Malpractice GPCI 0.671 changed to 0.720

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $116.27changed to$114.44

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.90 changed to 2.87

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $113.51changed to$116.27

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.65 changed to 2.90
    • Practice expense GPCI 0.856 changed to 0.842
    • Malpractice GPCI 0.521 changed to 0.671

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $112.27changed to$113.51

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.58 changed to 2.65
    • Malpractice RVU 0.11 changed to 0.09
    • Practice expense GPCI 0.870 changed to 0.856
    • Malpractice GPCI 0.370 changed to 0.521

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$112.27

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$107.79$36.18RVU26D
2026-07-01$107.79$36.18RVU26C
2026-04-01$107.79$36.18RVU26B
2026-01-01$107.79$36.18RVU26A
2025-10-01$105.40$42.28RVU25D
2025-07-01$105.40$42.28RVU25C
2025-04-01$105.40$42.28RVU25B
2025-01-01$105.40$42.28RVU25A
2024-10-01$110.45$43.23RVU24D
2024-07-01$110.45$43.23RVU24C
2024-04-01$110.45$43.23RVU24B
2024-03-09$110.45$43.23RVU24AR
2024-01-01$108.64$42.53RVU24A
2023-10-01$112.37$43.77RVU23D
2023-07-01$112.37$43.77RVU23C
2023-04-01$112.37$43.77RVU23B
2023-01-01$112.37$43.77RVU23A
2022-10-01$114.44$43.93RVU22D
2022-07-01$114.44$43.93RVU22C
2022-04-01$114.44$43.93RVU22B
2022-01-01$114.44$43.93RVU22A
2021-10-01$116.27$44.58RVU21D
2021-07-01$116.27$44.58RVU21C
2021-04-01$116.27$44.58RVU21B
2021-01-01$116.27$44.58RVU21A
2020-10-01$113.51$46.48RVU20D
2020-07-01$113.51$46.48RVU20C
2020-04-01$113.51$46.48RVU20B
2020-01-01$113.51$46.48RVU20A
2019-10-01$112.27$46.74RVU19D
2019-07-01$112.27$46.74RVU19C
2019-04-01$112.27$46.74RVU19B
2019-01-01$112.27$46.74RVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 11104 for an earlier date of service

Where the Mississippi rate applies

Mississippi is a Medicare payment area, not a city. Our Census mapping connects it to 427 cities and communities in Mississippi. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Aberdeen
  • Ackerman
  • Agricola
  • Alcorn State University
  • Algoma
  • Alligator
  • Amory

Browse all communities in Mississippi

11104 billing questions

When should I choose 11104 instead of 11102 or 11106?

Use 11104 when the clinician takes a cylindrical core with a punch instrument. Code 11102 is for tangential sampling, while 11106 is for incisional sampling.

How are additional punch-biopsied lesions reported?

Report 11104 for the first lesion and 11105 for each additional separate lesion sampled by punch in the same session.

Is simple closure separately reported?

Simple closure performed as part of the punch biopsy is included in the service.

Does modifier 50 apply to punch biopsies on both sides of the body?

No. CMS identifies bilateral adjustment as inappropriate for this code.

What documentation supports 11104?

Record the biopsy technique, the lesion’s location, the number of sampled lesions, and the clinical reason for obtaining tissue.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 11104PPRRVU2026_Oct_nonQPP.csv, line 1,272 (RVU26D)
Geographic factors for MississippiGPCI2026.csv, line 67 (RVU26D)

Open CMS sourceHow we calculate rates

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