$93.71–$109.75
Choose 11102 for tangential, superficial sampling; 11106 is for obtaining a full-thickness sample by incision.
On this page
CMS RVU26D · Effective 2026-10-01
11106 Skin biopsy Medicare reimbursement rates in Virginia
A clinician removes a full-thickness skin sample from one lesion by incision when tissue is needed for diagnostic pathologic examination. Compare 11106 office and facility rates across CMS payment localities in Virginia.
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 11106 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$148.18–$173.92
2 of 2 localities have a supported rate.
Facility setting
$45.08–$50.37
2 of 2 localities have a supported rate.
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 11106: Single-lesion incisional skin biopsy
A clinician removes a full-thickness skin sample from one lesion by incision when tissue is needed for diagnostic pathologic examination.
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.
CMS billing rules for 11106
- 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 RVU0.98 · 22%
- Practice expense (office) RVU3.43 · 76%
- Malpractice RVU0.12 · 3%
30.4K
Medicare services in 2024 · #973 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.
11106 compared with similar codes
Office rates for Virginia, from the same CMS release.
$118.81–$139.28
Choose 11104 when a punch instrument obtains the specimen. 11106 represents tissue taken by an incisional method.
$69.35–$81.09
11106 represents the first incisional biopsy lesion; 11107 reports each additional distinct lesion sampled by incision.
Compare 11106 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$173.92
Facility
$50.37
Virginia →
Office / nonfacility
$148.18
Facility
$45.08
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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 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.
1,27111103,,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
1,2771110T,,Strtctc icere dlvr 1 traj,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