# Skin Cancer Removal: Cost, Coverage, and What to Expect

Source: https://ourhealthnetwork.com/procedure-costs/skin-cancer-removal
Last reviewed: 2026-04-18
Data: CMS Hospital and Outpatient pricing, CPT/HCPCS code mapping

## Quick answer

Medicare pays about $399 on average per surgeon service for skin cancer removal across Mohs and standard excision. Your real out-of-pocket depends on how many Mohs stages are needed, where on the body the cancer sits, and whether pathology and reconstruction are billed separately.

## What it is

Skin cancer removal is surgery to cut out a cancerous or pre-cancerous growth, confirm the margins are clean, and close the wound. Most skin cancers treated this way are basal cell carcinoma, squamous cell carcinoma, and some early melanomas. The goal is to get the whole tumor out on the first try while preserving as much healthy tissue as possible, especially on the face.

There are two main approaches, and the one you get depends on where the cancer is and how aggressive it looks under the microscope.

**Mohs micrographic surgery** removes the visible tumor plus a thin rim of tissue, which is then frozen, sliced, and read under a microscope while you wait. If any cancer cells are left at the edge, the surgeon goes back for another precisely mapped layer. Each pass is called a "stage." Most Mohs cases finish in one or two stages, but tricky tumors can take three or four.

**Standard wide excision** removes the tumor with a pre-measured margin of healthy skin in a single cut, and the tissue is sent out to a pathology lab for reading (results come back days later). It's faster on the day of surgery but offers less precision on margins.

Here's what's typically involved on the day of surgery:

- Procedure time: 30 minutes for a simple excision, up to several hours for multi-stage Mohs with reconstruction
- Anesthesia: local injection only for nearly all cases, so you're awake
- Setting: dermatologist's office or outpatient procedure suite (roughly 95% of cases are office-based)
- Hospital stay: none for the vast majority
- Closure: simple stitches for small wounds; a skin flap or graft for larger or cosmetically sensitive areas

The seven procedure codes on this page cover the common variations: four Mohs codes that break down by body location (head/neck/hands vs. trunk/arms/legs) and by stage (first vs. each additional), plus three wide-excision codes that vary by lesion size and location. Most people will be billed at least one first-stage code and, if Mohs is used, one or more additional-stage codes.

## When it is done

A dermatologist usually recommends surgical removal after a skin biopsy has already come back positive for cancer or high-grade pre-cancer. Surgery is the first-line treatment for most basal cell and squamous cell carcinomas because cure rates are high when margins come back clean.

Your doctor may recommend this when:

1. A biopsy confirms basal cell or squamous cell carcinoma that hasn't spread
2. The tumor sits on a cosmetically or functionally sensitive area like the nose, eyelid, ear, or lip, where Mohs is strongly preferred to preserve tissue
3. The cancer has recurred after an earlier treatment such as topical chemo or curettage
4. The tumor is large (over 2 cm on the face or over 4 cm on the body) or has aggressive features under the microscope
5. A previous excision came back with positive margins meaning cancer was left behind
6. You're immunosuppressed, which raises the risk of aggressive behavior and recurrence

For very small, low-risk superficial basal cell carcinomas, non-surgical options like topical imiquimod, 5-fluorouracil cream, photodynamic therapy, or electrodesiccation and curettage may be offered. These are cheaper in the short term but have higher recurrence rates in many locations. If your dermatologist recommends surgery over a cream, it's usually because the cancer's location, depth, or type makes non-surgical treatment riskier. Melanoma is almost always treated with wide excision by a surgical oncologist or plastic surgeon, not Mohs.

## What you pay

Medicare pays an average of about $399 per surgeon service across the skin cancer removal codes in the claims data, but that number hides a lot of variation. A single first-stage Mohs on the face (17311) averages $448, while each add-on stage (17312) averages $315. A wide excision of a mid-size face lesion (11643) averages just $154 because the code reimburses less than Mohs. The total you actually owe depends on your insurance, how many stages you need, and whether reconstruction and pathology get billed separately.

**If you're on Medicare:**

- Part B covers outpatient skin cancer surgery after you meet the annual Part B deductible of $257 in 2025
- You pay 20% coinsurance on the Medicare-approved amount after the deductible, with no cap under original Medicare
- Medicare Advantage plans often have a copay per visit (commonly $25-$75) plus an annual out-of-pocket max
- Medigap (supplemental) plans cover most or all of the 20% coinsurance, which is why many Mohs patients pay $0 at checkout

**If you have commercial insurance:**

- Commercial plans typically pay dermatologists 2x to 4x Medicare rates, so billed amounts of $1,000-$3,000 per stage are common before contract adjustments
- Your share depends on your plan's deductible, coinsurance (often 20%), and in-network status; total out-of-pocket for a complete Mohs case often lands between $200 and $2,000
- Your ACA out-of-pocket max in 2025 caps total in-network costs at $9,200 individual or $18,400 family, so even a complicated multi-stage case with reconstruction won't exceed that ceiling
- A high-deductible plan may mean you pay close to the full negotiated rate until the deductible is met

**If you're uninsured or paying cash:**

- Many dermatology practices offer a cash-pay or self-pay discount, often 20-40% off the chargemaster, if you pay at the time of service
- Ask whether the office can quote a bundled cash-pay price that includes surgeon fee, pathology, and closure, rather than billing each separately
- Hospital-affiliated dermatology groups have charity care and financial assistance policies; ask about the sliding scale before the procedure
- Community health centers and academic dermatology programs sometimes offer reduced-fee clinics with resident dermatologists supervised by faculty

## Anatomy of the bill

A skin cancer removal rarely shows up as a single line item. Even a simple case often produces several bills from several billing parties.

**Surgeon fee:** This is the core charge for the dermatologist's time performing the Mohs stages or excision. Medicare pays between $154 and $448 depending on code; commercial is typically 2-4x that. Billed by the dermatologist's practice.

**Facility fee:** If you're in a hospital outpatient department or an ambulatory surgery center, a separate facility fee is billed. Office-based dermatology procedures (about 95% of cases in the data) don't generate a separate facility fee. Medicare's facility-setting average is just $187 for the surgeon portion because the facility is paid separately.

**Pathology / microscopic interpretation:** For Mohs surgery, microscopic reading is bundled into the stage code (one of the reasons Mohs codes pay more). For a standard excision (11604, 11606, 11643), the tissue is sent to an outside pathology lab and you'll get a separate bill, usually $100-$400 depending on contract.

**Repair and reconstruction:** If the defect needs more than simple stitches, the surgeon bills a separate repair code. An intermediate closure typically adds $200-$600 Medicare; a skin flap or full-thickness graft can add $400-$1,500+ Medicare, and commercial plans pay multiples of that.

**Pre-op biopsy:** If your cancer was diagnosed by biopsy in an earlier visit, that biopsy plus its pathology is a separate older bill, often $50-$250 out-of-pocket.

**Local anesthesia supplies:** Usually bundled into the surgical code. You will not get a separate anesthesiologist bill for office-based cases since local injection is done by the dermatologist.

**Dressing and follow-up visits:** Suture removal and wound checks are typically included in a 10- or 90-day global period, meaning they don't generate new charges. Complications that fall outside the global period do.

## Cost by state

Florida tops the country for skin cancer removal volume, with 392,592 Medicare services in the data, followed by California (339,529), Texas (182,314), New York (160,675), and New Jersey (119,863). That ranking tracks sun exposure, age of population, and dermatologist density. For the volume-weighted surgeon Medicare payment, Vermont comes in cheapest at $237 while Alaska is priciest at $510, though both are small-volume outliers. Among the high-volume states, California ($444), New York ($440), and Maryland ($433) sit at the top end; Pennsylvania ($341) and Wisconsin ($295) sit at the bottom.

Why costs vary by state:

- Medicare's Geographic Practice Cost Index (GPCI) adjusts physician payment up or down by region, which accounts for most of the state-level spread in Medicare rates
- Commercial insurance negotiations vary by market competition; dense dermatology markets like Florida and Texas can have tighter contracts, while isolated states like Alaska have fewer providers and higher rates
- Cost of living and real-estate costs flow into what practices charge privately, even when Medicare is fixed
- State surprise-billing laws and scope-of-practice rules affect which parties can bill and at what rate
- Case mix matters: states with more Mohs-trained surgeons see a higher share of 17311/17312 codes, which pay more than standard excisions

## Office vs facility

Skin cancer removal is almost entirely an office-based procedure. Medicare data shows 1,589,137 services performed in office settings versus just 74,509 in facilities, meaning fewer than 5% of cases happen in a hospital outpatient department or ambulatory surgery center. The real cost comparison for most patients is not office vs. facility, it's dermatology office vs. hospital-affiliated dermatology clinic, since hospital-based clinics can bill a separate facility fee on top of the surgeon fee.

When a dermatology office makes more sense:

- Routine Mohs or excision on a cooperative adult under local anesthesia, which describes the vast majority of cases
- Lower total bill because there's no facility fee stacked on the surgeon fee
- Same-day reading of Mohs stages by the surgeon in the office lab
- Easier scheduling and shorter wait times

When a hospital or ASC setting makes more sense:

- Very large tumors or defects that need general anesthesia or IV sedation
- Patients on blood thinners that can't be held, or with serious cardiac or bleeding issues
- Cases where a plastic surgeon is doing the reconstruction in a shared OR
- Immunocompromised patients who benefit from a sterile hospital suite

Before you schedule, ask whether the dermatology clinic is billed as a physician office or a "hospital outpatient department." The second one costs more even when the procedure is identical.

## Who performs the procedure

This surgery is overwhelmingly a dermatology procedure. The data shows 2,756 general dermatologists and 478 fellowship-trained micrographic dermatologic surgeons (MDS), who together account for more than 95% of all services. Plastic surgeons, surgical oncologists, general surgeons, and ENTs each show up in smaller numbers, usually for larger or anatomically complex cases.

For Mohs specifically, fellowship-trained Mohs surgeons are the gold standard. They've completed an additional 1-2 year Mohs fellowship accredited by the American College of Mohs Surgery (ACMS) and read their own slides. A general dermatologist can also perform Mohs, but Mohs College fellowship training is the signal many patients look for.

What to look for when choosing a specialist:

- Volume: ask how many cases of your specific cancer type they do per year; hundreds per year is common for busy Mohs surgeons
- Board certification in dermatology, plus Mohs fellowship for cosmetically sensitive locations like the face, nose, or eyelid
- Clear cure-rate data for your tumor type (Mohs cure rates for primary basal cell carcinoma are typically 98-99%)
- A discussion of reconstruction upfront, including who will close the defect and whether a plastic surgeon is part of the team for large facial wounds
- Willingness to give you a written cost estimate and explain what's bundled vs. separately billed
- A second opinion if you're offered Mohs for a low-risk body tumor that could be treated with simpler excision at lower cost

Very low-volume specialties in the data (physician assistants with 39 providers, otolaryngology with 31) are rarely the primary surgeon on a skin cancer case. PAs typically assist or handle post-op wound care under a supervising dermatologist. ENTs step in mostly for nasal or ear reconstruction after Mohs clears the margin.

## How to shop for the best price

Skin cancer removal isn't a true shoppable procedure the way a knee replacement is, but you can still cut your bill by asking the right questions in the right order.

1. Get a Good Faith Estimate in writing. Federal law (the No Surprises Act) requires providers to give uninsured or self-pay patients a written estimate before the procedure; insured patients can request one too. Ask for line items covering surgeon, pathology, reconstruction, and any facility fee.
2. Verify every billing party is in-network. A Mohs case can generate bills from the surgeon, a separate pathologist (for non-Mohs excisions), a plastic surgeon (if reconstruction is handed off), and the facility. Confirm each one by name against your insurer's directory.
3. Compare a physician-office dermatology clinic against a hospital outpatient dermatology clinic. The second one can add hundreds of dollars in facility fees for the same procedure. Ask the clinic billing department which category they're in.
4. Ask about bundled vs. itemized pricing. Some practices will quote a cash-pay bundle that covers the stage codes, pathology, and simple closure as one number. That's usually cheaper than paying each line separately.
5. Ask about financial assistance and payment plans. Hospital-owned practices are required to have charity-care policies. Independent practices often offer 0% interest payment plans if you ask at scheduling, not after the bill arrives.
6. For low-risk body cancers, ask whether standard excision (11604/11606) would be as effective as Mohs. Standard excision pays about half of Mohs per stage and often suffices for small, low-risk trunk or limb tumors.
7. Confirm the reconstruction plan before the day of surgery. If a skin flap or graft is likely, get that specific CPT code and expected out-of-pocket into the Good Faith Estimate.

Watch for red flags: refusal to give a written estimate, vague language about "additional charges if needed," unclear answers about who reads your pathology, and any practice that won't name which closure codes they expect to bill. Any of those is a reason to get a second quote.

## Surprise billing risks

Skin cancer removal has fewer surprise-billing landmines than an inpatient surgery, but they do exist and they tend to show up a few weeks later on a separate statement.

Most common surprise-billing sources for this procedure:

- Outside pathology lab reading the specimen from a standard excision (not Mohs), where the lab may be out-of-network even though your dermatologist is in-network
- Reconstruction handoff to a plastic surgeon who turns out to be out-of-network with your plan
- Facility fees from a dermatology clinic that is technically part of a hospital outpatient department rather than a physician office
- A second Mohs stage you didn't expect, billed as an additional 17312 or 17314 that pushes you past your deductible
- Repair codes (intermediate closure, flap, graft) that weren't itemized in the pre-op estimate

If you get a surprise bill:

- Don't pay until you've verified every line against an itemized statement and your Explanation of Benefits; mistakes are common
- For out-of-network charges at an in-network facility, invoke the federal No Surprises Act of 2022; patient protections for ancillary providers apply at in-network facilities
- File a complaint or arbitration request through the federal No Surprises help desk at cms.gov/nosurprises, which has a patient-facing portal
- Escalate to your state insurance commissioner, which often has a dedicated consumer help line that can intervene directly with the plan

## Total recovery cost

Recovery from most skin cancer removal surgeries is short. A body excision or simple Mohs with stitches usually heals in 10-14 days, with sutures removed at that point and a small scar that continues to fade for a year. A face case with a flap or graft takes longer, often 4-6 weeks to look presentable, with full scar maturation out to a year. Most people return to desk work within a day or two and to heavy exercise within 2-3 weeks.

Add-on costs to budget for:

- Suture removal visit: usually $0 because it falls inside the 10- or 90-day global period, but confirm
- Prescription pain medication: typically acetaminophen or a short course of tramadol, $5-$50 depending on coverage
- Oral or topical antibiotics if prescribed: $10-$40 generic
- Wound care supplies (gauze, petroleum ointment, adhesive bandages): $20-$60 over the healing period
- Scar treatment if you choose it (silicone sheets, massage, laser sessions): $30-$300 for at-home products, $300-$1,500+ for laser revision if desired
- Follow-up skin checks every 6-12 months for life, because a personal history of skin cancer raises future risk significantly: $100-$300 per visit or a copay on insurance
- Time off work: usually 0-3 days for body cases, up to a week for complex facial reconstruction; factor lost wages if you're hourly

The realistic all-in episode cost for a straightforward Mohs case on the face with a simple closure runs about 15-25% higher than the headline surgeon fee once pathology, reconstruction, prescription medications, and a follow-up or two are totaled. For commercial patients, that often lands in the $1,000 to $2,500 out-of-pocket range after insurance. Uninsured patients negotiating a bundled cash-pay rate typically save the most per case.

## Variants of this procedure

- Wide Excision, Body (3-4 cm)
- Wide Excision, Body (Over 4 cm)
- Wide Excision, Face (2-3 cm)
- Mohs Surgery, First Stage (Face/Hands)
- Mohs Surgery, Additional Stage (Face/Hands)
- Mohs Surgery, First Stage (Body)
- Mohs Surgery, Additional Stage (Body)

## Frequently asked questions

### How much does skin cancer removal cost with insurance?

With commercial insurance, most patients end up paying a few hundred to about $2,000 out of pocket after deductible and coinsurance, depending on how many Mohs stages are needed and whether reconstruction is billed separately. Your ACA out-of-pocket maximum in 2025 caps total in-network costs at $9,200 individual or $18,400 family.

### Does Medicare cover skin cancer removal?

Yes. Medicare Part B covers medically necessary skin cancer surgery, paying about $399 on average per surgeon service in our data. After the 2025 Part B deductible of $257, you owe 20% coinsurance. Medigap or Medicare Advantage plans can reduce or cap that further.

### How long is recovery after Mohs or excision?

Most body cases heal in 10-14 days, and most people return to work within 1-2 days. Face cases with a flap or graft take 4-6 weeks to look presentable and a year to fully mature. Follow wound care instructions to minimize scarring.

### Is this outpatient or does it require a hospital stay?

Nearly always outpatient. About 95% of skin cancer removals are done in a dermatology office under local anesthesia, and you go home the same day. A hospital setting is reserved for very large tumors, patients who need general anesthesia, or complex reconstructions.

### What's the difference between Mohs surgery and standard excision?

Mohs removes the tumor in thin layers and reads each layer under the microscope during the visit, so the surgeon can go back for more tissue only where cancer remains. Standard excision cuts out the tumor with a fixed margin in one pass and sends the tissue to a lab for reading days later. Mohs is more precise and tissue-sparing for face cases but costs more per stage.

### How do I avoid a surprise bill?

Get a written Good Faith Estimate, confirm in-network status for the surgeon, the pathologist, the reconstruction surgeon, and the facility, and ask whether the clinic is billed as a physician office or hospital outpatient department. File any disputes through cms.gov/nosurprises under the No Surprises Act of 2022.

### What's the cheapest way to get skin cancer removal?

For small, low-risk cancers on the trunk or limbs, standard wide excision in a physician-office dermatology clinic is usually the least expensive surgical option. For uninsured patients, ask for a bundled cash-pay quote and check community health centers, academic dermatology clinics, and hospital charity care programs before scheduling.

### Where does this cost data come from?

Medicare payment averages come from the Centers for Medicare and Medicaid Services Physician and Other Practitioners public use data. They reflect surgeon fees for 2024 service dates across about 2,969 providers and 1.66 million services nationally. Commercial and cash-pay estimates are stated as ranges or multiples of Medicare, since those prices aren't publicly reported.

## Related

- [All procedure cost concepts](https://ourhealthnetwork.com/procedure-costs)
- [Find specialists who perform this procedure](https://ourhealthnetwork.com/find-doctors)
- [Insurance plans that cover this procedure](https://ourhealthnetwork.com/tools/insurance-matcher)