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CPT 11105: Additional Punch Biopsy of Skin Lesion
CPT code 11105 denotes an additional or separate punch biopsy of the skin performed with a sharp hollow instrument and is reported per lesion in addition to the primary punch biopsy code. Punch biopsies are commonly used to obtain full-thickness circular samples of skin for diagnostic evaluation of deeper or suspicious lesions. Nationally, accurate reporting of additional lesion biopsies affects claims adjudication, clinical documentation, and procedure-level utilization metrics for dermatologic services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical usage and coding context for 11105, comparisons to closely related codes such as 11104 and 11106, and guidance on typical settings where the procedure is performed. The publication summarizes common billing considerations and the clinical scenarios that prompt use of additional punch biopsies, providing stakeholders with a clear understanding of how the code is applied in practice. It also outlines expected documentation elements and national-level significance for procedural tracking and reimbursement workflows.
This summary is intended for a national audience of clinical administrators, coding professionals, and policy analysts seeking a focused briefing on the role and implications of CPT code 11105.
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Billing Code Overview
CPT code 11105 describes a punch biopsy of an additional or separate skin lesion performed with a sharp hollow instrument. This code is reported for each separate or additional lesion biopsied after the primary punch biopsy procedure.
Service Type: Skin biopsy (punch) for additional lesion
Typical Site of Service: Outpatient dermatology clinic or office-based setting, including procedure rooms where minor dermatologic procedures are performed.
National Reimbursement Benchmarks
Medicare’s mean rate for CPT 11105 sits at $62.6, while BUCA’s mean commercial rate is notably higher at $122.6, indicating that average commercial reimbursements from BUCA are roughly $60 greater than Medicare for this code. Blue Cross Blue Shield, Cigna, Aetna, and UnitedHealth Group all show mean rates that span between these two anchors, creating a commercial-to-Medicare spread that clinics will see across payers.
Assessing dispersion via the interquartile range (P75–P25), Blue Cross Blue Shield is the widest with a spread of $75.6 ($202.2–$126.6), followed by UnitedHealth Group at $55.3 ($105.3–$49.7) and Cigna at $55.6 ($90.7–$37.1). Aetna is much tighter with a spread of $41.5 ($63.7–$22.0), and BUCA’s interquartile spread is $64.8 ($152.7–$87.9). These differences highlight which payers exhibit greater variability in middle-range reimbursements versus those with more compressed bands.