$108.54
11104 reports the first lesion biopsied by punch; 11105 reports each additional separate lesion biopsied by punch in the session.
On this page
CMS RVU26D · Effective 2026-10-01
11105 Skin biopsy Medicare reimbursement rates in Alabama
Reports an additional punch biopsy of a distinct skin lesion during the same session as the first punch biopsy. Compare 11105 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 11105 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$54.01
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
$19.82
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Dermatology procedure
About 11105: Additional punch biopsy of skin lesion
Reports an additional punch biopsy of a distinct skin lesion during the same session as the first punch biopsy.
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.
CMS billing rules for 11105
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.44 · 24%
- Practice expense (office) RVU1.30 · 72%
- Malpractice RVU0.07 · 4%
82.3K
Medicare services in 2024 · #618 by national volume
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.
11105 compared with similar codes
Office rates for Alabama, from the same CMS release.
$43.80
Both represent an additional lesion, but 11103 is for tangential sampling and 11105 is for punch sampling.
$63.55
Both represent an additional lesion, but 11107 is for incisional sampling and 11105 is for punch sampling.
Compare 11105 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$54.01
Facility
$19.82
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 11105 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
1,273
- Code
- 11105
- Physician work
- 0.44
- Practice expense
- 1.30
- Malpractice
- 0.07
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.44 | × 1.000 | 0.4400 |
| Practice expense | 1.30 | × 0.875 | 1.1375 |
| Malpractice | 0.07 | × 0.566 | 0.0396 |
| Total RVUs | 1.6171 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$54.01
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.44 | 1 |
| Practice expense | 1.3 | 0.875 |
| Malpractice | 0.07 | 0.566 |
(0.44 × 1 + 1.3 × 0.875 + 0.07 × 0.566) × $33.4009 = $54.01
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.44 | 1 |
| Practice expense | 0.13 | 0.875 |
| Malpractice | 0.07 | 0.566 |
(0.44 × 1 + 0.13 × 0.875 + 0.07 × 0.566) × $33.4009 = $19.82
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,27011102,,Tangntl bx skin single les,A,,0.64,2.16,,0.20,,0.06,2.86,0.90,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,27111103,,Tangntl bx skin ea sep/addl,A,,0.37,1.05,,0.12,,0.04,1.46,0.53,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,27211104,,Punch bx skin single lesion,A,,0.81,2.73,,0.24,,0.09,3.63,1.14,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,27311105,,Punch bx skin ea sep/addl,A,,0.44,1.30,,0.13,,0.07,1.81,0.64,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,27411106,,Incal bx skn single les,A,,0.98,3.43,,0.29,,0.12,4.53,1.39,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,27511107,,Incal bx skn ea sep/addl,A,,0.53,1.53,,0.16,,0.06,2.12,0.75,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,2761110F,,Pt lft inpt fac w/in 60 days,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515