CPT code 11106: Skin biopsy, single incisional lesion2026 Medicare rate & RVUs in Texas
A clinician removes a full-thickness skin sample from one lesion by incision when tissue is needed for diagnostic pathologic examination.
Medicare pays $140.71–$157.56 for 11106 in the office in Texas, from Beaumont, TX to Austin, TX. 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 11106 covers
An incisional skin biopsy removes a portion of one lesion through the skin’s full thickness, typically using a blade to obtain tissue that may include epidermis, dermis, and subcutaneous tissue. Dermatologists, surgeons, and other clinicians may perform it in an office or outpatient setting when a representative sample is needed for pathology rather than removal of the entire lesion. The method distinguishes this service from a superficial tangential shave or a punch specimen.
Report 11106 for one lesion sampled by incision; document the site, the lesion sampled, and the technique. For another distinct lesion sampled by the same method, 11107 is the related add-on code. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this single-lesion service. Assistant-at-surgery services are not paid, and co-surgeons and team surgery 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.
Where 11106 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$140.71 to $157.56
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $157.56 | $46.60 |
| Beaumont, TX | $140.71 | $45.27 |
| Brazoria, TX | $149.66 | $45.72 |
| Dallas, TX | $150.57 | $46.11 |
| Fort Worth, TX | $149.48 | $46.07 |
| Galveston, TX | $150.08 | $45.93 |
| Houston, TX | $152.27 | $48.13 |
| Rest of Texas | $145.07 | $45.54 |
How the 11106 rate is calculated
Each of 11106’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 · 11106
RVUs × geographic indexes × conversion factor
Work0.98
0.98 RVUs× 1.000 GPCI
Practice expense3.43
3.43 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
4.5300
Conversion factor
$33.4009
Medicare rate
$151.31
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11106
The CMS indicators that decide how 11106 is paid alongside other services.
CMS payment indicators · 11106
Skin biopsy, single incisional lesion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11106 without 51 · national office
$151.31
Skin biopsy, single incisional lesion
11106-51 · Second procedure: 50%
$75.66
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%).
11106 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 11102Tangential skin biopsyFirst or only lesion
- Choose 11102 for tangential, superficial sampling; 11106 is for obtaining a full-thickness sample by incision.
- 11104Punch biopsySingle skin lesion
- Choose 11104 when a punch instrument obtains the specimen. 11106 represents tissue taken by an incisional method.
- 11107Skin biopsyEach additional lesion
- 11106 represents the first incisional biopsy lesion; 11107 reports each additional distinct lesion sampled by incision.
11106 billing questions
How is 11106 different from a punch biopsy?
11106 represents tissue taken by incision, typically with a blade. Use 11104 when the clinician obtains the specimen with a punch instrument.
When is 11102 more appropriate?
11102 is for tangential, superficial sampling of a skin lesion. Choose 11106 when the clinician takes an incisional, full-thickness sample.
Can 11106 be reported for more than one lesion?
11106 represents one lesion. For each additional distinct lesion sampled by incision, report the related add-on code 11107.
Should modifier 50 be appended for lesions on both sides of the body?
No. Modifier 50 is inappropriate for 11106; report the service based on the individual lesion sampled.
What documentation supports reporting 11106?
Document the lesion’s site, that tissue was obtained by incision, and the clinical reason for sampling. Identify distinct lesions when reporting an additional-lesion service.
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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