CPT
10060 — Incision and drainage of abscess, simple
If just one abscess and simple drainage, 10060 is the correct code.
Dermatology
11104 — Punch biopsy of skin; single lesion
This code covers the removal of a small skin sample using a circular punch tool for laboratory analysis.
- Typical setting: Dermatology clinic, hospital
- National avg charge (illustrative): $80-$185 Medicare allowed (approx. $90-$150 national Medicare average; commercial payers $120-$250)
- Most-disputed reason: Upcoding to 11106: billing the incisional biopsy code when a punch biopsy was actually performed — the technique must match the code
What it means
What 11104 actually means
This code covers the removal of a small skin sample using a circular punch tool for laboratory analysis. The doctor pushes the punch through the skin to take a cylindrical biopsy sample, usually 3-6 mm in diameter. This is commonly used to diagnose rashes, suspicious moles, or other skin conditions. The 10-day global period includes simple wound care after the procedure.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Upcoding to 11106: billing the incisional biopsy code when a punch biopsy was actually performed — the technique must match the code
- Separate pathology billing confusion: patients sometimes receive two bills — one from the dermatologist (11104) and one from the pathologist (88305) — which is correct but can appear as a duplicate to patients
- Bilateral or multiple lesion billing without add-on: billing multiple units of 11104 instead of billing 11104 once and using add-on code 11105 for each additional lesion
If you see 11104 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 11104 often also see these adjacent codes on the same bill.
CPT
11042 — Debridement, subcutaneous tissue; first 20 sq cm or less
Verify the code matches the actual service and dose.
CPT
11102 — Skin biopsy, tangential (single lesion)
First biopsy at full price; additional biopsies use add-on codes (11103).
CPT
11106 — Incisional biopsy of skin; single lesion
Verify the code matches the actual service and dose.
CPT
11400 — Excision benign lesion, except skin tag, trunk/arms/legs; 0.5 cm or less
Verify the code matches the actual service and dose.
CPT
11600 — Excision malignant lesion, trunk/arms/legs; 0.5 cm or less excised diameter
Verify the code matches the actual service and dose.
Related BillBusted guides
Plain-English reads if you see 11104 on a bill.
11104 FAQ
Plain-English answers.
What does 11104 usually cost?
$80-$185 Medicare allowed (approx. $90-$150 national Medicare average; commercial payers $120-$250). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 11104?
Upcoding to 11106: billing the incisional biopsy code when a punch biopsy was actually performed — the technique must match the code
What should I do if I see 11104 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 11104 before paying.
Don't pay 11104 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.