Common office procedures

11104 - RVUs & Medicare payment (2026)

Skin biopsy, punch, first lesion.

Component	Non-facility	Facility
Work RVU	0.81	0.81
Practice expense RVU	2.73	0.24
Malpractice RVU	0.09	0.09
Total RVUs	3.63	1.14
National payment (CF $33.4009)	$121.25	$38.08
Qualifying APM payment (CF $33.5675)	$121.85	$38.27

How 11104 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 11104 ranges from $106.93 in Arkansas (AR) to $163.13 in San Jose-Sunnyvale-Santa Clara (CA); calculate 11104 for your locality.

San Jose-Sunnyvale-Santa Clara (CA) $163.13 San Jose-Sunnyvale-Santa Clara (CA) $162.71 San Francisco-Oakland-Berkeley (CA) $159.57 San Francisco-Oakland-Berkeley (CA) $159.47 Napa (CA) $150.47 Vallejo (CA) $150.32 NYC Suburbs/Long Island (NY) $142.79 Seattle (WA) $142.75 National average $121.25 … 97 more localities between … Rest Of Missouri (MO) $108.58 Alabama (AL) $108.54 Mississippi (MS) $107.79 Arkansas (AR) $106.93

Non-facility payment for 11104 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: 000

Same-day global period: related visits on the day of the procedure are included in the payment.

Related codes - common office procedures

10060 · incision and drainage of abscess, simple
11102 · skin biopsy, tangential, first lesion
11200 · removal of skin tags, up to 15
11730 · nail plate avulsion, partial or complete, first
11042 · debridement, subcutaneous tissue, first 20 sq cm
12001 · simple wound repair, scalp/trunk/extremities, 2.5 cm or less
17000 · destruction of premalignant lesion, first
17003 · destruction of premalignant lesions, 2-14, each
17110 · destruction of benign lesions, up to 14
20610 · aspiration or injection of major joint (knee, shoulder, hip)
20552 · trigger point injection, 1-2 muscles
69210 · removal of impacted earwax, unilateral

Frequently asked questions

How much does Medicare pay for 11104 in 2026?

The national non-facility payment is $121.25 and the facility payment is $38.08, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.

What is the work RVU for 11104?

The 2026 work RVU for 11104 is 0.81. Total RVUs are 3.63 in the non-facility setting and 1.14 in the facility setting.

Why are the facility and non-facility amounts different?

Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.