CPT code 11105: Skin biopsy, each additional punch-biopsied lesion2026 Medicare rate & RVUs in California
Reports an additional punch biopsy of a distinct skin lesion during the same session as the first punch biopsy.
Medicare pays $63.79–$80.18 for 11105 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 11105 covers
This code represents a punch biopsy of an additional, separate skin lesion after the first lesion is biopsied by the punch method. A clinician uses a circular punch instrument to remove a tissue sample for diagnostic evaluation, commonly when assessing a suspicious lesion or skin change. Dermatologists and other clinicians who evaluate skin conditions may perform the procedure in an office or facility setting.
Report one unit for each additional distinct lesion biopsied by punch during the session; the first punch-biopsied lesion is represented by 11104. Documentation should identify the separate lesion sites and support why each required biopsy. This is an add-on code: report it only with the primary procedure, 11104, and payment is within that procedure's global period. It is not a standalone punch-biopsy service.
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.
Where 11105 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$63.79 to $80.18
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $63.99 | $21.16 |
| Chico, CA | $63.79 | $20.96 |
| El Centro, CA | $63.80 | $20.97 |
| Fresno, CA | $63.79 | $20.96 |
| Hanford, CA | $63.79 | $20.96 |
| Los Angeles, CA | $68.22 | $21.99 |
| Madera, CA | $63.79 | $20.96 |
| Marin County, CA | $78.39 | $23.29 |
| Merced, CA | $63.79 | $20.96 |
| Modesto, CA | $63.79 | $20.96 |
| Napa, CA | $74.04 | $22.53 |
| Oxnard, CA | $67.89 | $21.70 |
| Redding, CA | $63.79 | $20.96 |
| Rest of California | $63.79 | $20.96 |
| Riverside, CA | $64.54 | $21.71 |
| Sacramento, CA | $66.98 | $21.53 |
| Salinas, CA | $66.73 | $21.44 |
| San Benito County, CA | $80.18 | $23.83 |
| San Diego, CA | $68.34 | $21.60 |
| San Francisco, CA | $78.31 | $23.21 |
| San Luis Obispo, CA | $65.66 | $21.15 |
| Santa Clara County, CA | $79.85 | $23.50 |
| Santa Cruz, CA | $69.01 | $21.53 |
| Santa Maria, CA | $66.99 | $21.42 |
| Santa Rosa, CA | $69.71 | $21.72 |
| Stockton, CA | $63.79 | $20.96 |
| Vallejo, CA | $73.92 | $22.42 |
| Visalia, CA | $63.79 | $20.96 |
| Yuba City, CA | $63.79 | $20.96 |
How the 11105 rate is calculated
Each of 11105’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 · 11105
RVUs × geographic indexes × conversion factor
Work0.44
0.44 RVUs× 1.000 GPCI
Practice expense1.30
1.30 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
1.8100
Conversion factor
$33.4009
Medicare rate
$60.46
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11105
The CMS indicators that decide how 11105 is paid alongside other services.
CMS payment indicators · 11105
Skin biopsy, each additional punch-biopsied lesion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
11105 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 11104Punch biopsySingle skin lesion
- 11104 reports the first lesion biopsied by punch; 11105 reports each additional separate lesion biopsied by punch in the session.
- 11103Tangential skin biopsyEach separate or additional lesion
- Both represent an additional lesion, but 11103 is for tangential sampling and 11105 is for punch sampling.
- 11107Skin biopsyEach additional lesion
- Both represent an additional lesion, but 11107 is for incisional sampling and 11105 is for punch sampling.
11105 billing questions
Which code reports the first punch-biopsied lesion?
Use 11104 for the first lesion. Code 11105 represents each additional, separate lesion biopsied by punch during the session.
Can 11105 be billed without 11104?
No. It is an add-on code and must be reported with 11104, the primary punch-biopsy code.
Does each punch sample require a unit of 11105?
Report a unit for each additional distinct lesion, not for multiple samples taken from the same lesion. Document the separate sites biopsied.
When should 11103 be used instead?
Use 11103 for each additional lesion sampled by the tangential method. Use 11105 when the additional lesion is biopsied with a punch.
How does the global-period rule affect 11105?
11105 is billed with 11104, and its payment is within the primary procedure's global period.
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
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