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CPT 11107: Additional Incisional/Wedge Skin Lesion Biopsy
CPT code 11107 represents an additional or separate skin lesion biopsy performed using an incisional or wedge technique and is reported in addition to the primary lesion biopsy code 11106. This code captures provider work for biopsying large or deep lesions that require partial sampling rather than complete excision, and it is used when multiple discrete lesions are sampled in the same session. Nationally, accurate reporting of 11107 affects clinical documentation, procedure-level utilization tracking, and appropriate payment for incremental surgical effort.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for 11107, common service settings, and how it relates to the primary incisional biopsy code. The publication provides benchmarks and policy-relevant notes about reporting practices, coding guidance on when to append 11107 alongside the primary code, and comparisons across major payers regarding coverage nuances and claim adjudication patterns.
This summary is intended to inform clinicians, billing staff, and policy analysts about the role of CPT code 11107 in surgical dermatology coding workflows, documentation requirements for multiple lesion biopsies, and common considerations when reconciling procedure reporting with payer rules.
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Billing Code Overview
CPT code 11107 describes an additional or separate skin lesion biopsy performed using an incisional or wedge technique. This code is reported in addition to the primary lesion biopsy code when a provider biopsies one or more additional or separate lesions during the same encounter.
Service type: Surgical skin biopsy (incisional/wedge) for additional or separate lesions
Typical site of service: Outpatient dermatology clinic, ambulatory surgical center, or physician office where minor surgical dermatologic procedures are performed.
National Reimbursement Benchmarks
National averages place Blue Cross Blue Shield and other commercial panels above Medicare for CPT 11107: Blue Cross Blue Shield’s mean of $170.3 and the BUCA mean of $128.2 both exceed Medicare’s mean of $73.4, with BUCA sitting roughly $54.8 higher than Medicare and Blue Cross Blue Shield about $96.9 above Medicare. UnitedHealth Group ($96.2 mean), Cigna ($82.9 mean) and Aetna ($37.3 mean) span the commercial spectrum, creating a clear separation between Medicare and many commercial payers.
Dispersion measured as P75 minus P25 highlights variability across payers. Blue Cross Blue Shield is the widest with a spread of $79.4 (P75 $210.5 minus P25 $131.1), followed by UnitedHealth Group at $62.9 and Cigna at $63.7. Aetna exhibits the tightest interquartile spread at $47.0, while BUCA’s interquartile range is $69.5 and Medicare’s IQR is $8.0, indicating Medicare rates are relatively stable compared with most commercial payers.