$60.11
Use 11105 for each additional separate lesion sampled by punch after the first; 11104 represents the first punch-biopsied lesion.
On this page
CMS RVU26D · Effective 2026-10-01
11104 Punch biopsy Medicare reimbursement rates in Nevada
A punch biopsy removes a cylindrical skin sample from one lesion for diagnostic examination when a core specimen is needed. Compare 11104 office and facility rates across CMS payment localities in Nevada.
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 11104 in Nevada?
Nevada 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
$120.83
1 of 1 localities have a supported rate.
Payment area: Nevada**
One mapped payment locality.
Facility setting
$37.58
1 of 1 localities have a supported rate.
Payment area: Nevada**
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 11104: Single-lesion skin punch biopsy
A punch biopsy removes a cylindrical skin sample from one lesion for diagnostic examination when a core specimen is needed.
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.
CMS billing rules for 11104
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU0.81 · 22%
- Practice expense (office) RVU2.73 · 75%
- Malpractice RVU0.09 · 2%
286.1K
Medicare services in 2024 · #322 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.
11104 compared with similar codes
Office rates for Nevada, from the same CMS release.
Compare 11104 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
Nevada** →
Office / nonfacility
$120.83
Facility
$37.58
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 11104 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
1,272
- Code
- 11104
- Physician work
- 0.81
- Practice expense
- 2.73
- Malpractice
- 0.09
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.81 | × 1.000 | 0.8100 |
| Practice expense | 2.73 | × 1.001 | 2.7327 |
| Malpractice | 0.09 | × 0.833 | 0.0750 |
| Total RVUs | 3.6177 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nevada**$120.83
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.81 | 1 |
| Practice expense | 2.73 | 1.001 |
| Malpractice | 0.09 | 0.833 |
(0.81 × 1 + 2.73 × 1.001 + 0.09 × 0.833) × $33.4009 = $120.83
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.81 | 1 |
| Practice expense | 0.24 | 1.001 |
| Malpractice | 0.09 | 0.833 |
(0.81 × 1 + 0.24 × 1.001 + 0.09 × 0.833) × $33.4009 = $37.58
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.
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 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.
1,2691109T,,Strtctc icere impl 1+mlt trj,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097