What is the top of the local market (P90) for CPT 11301 under Bcbsil for Kalamazoo-Portage, MI providers?

The P90, the top of the local market and Reddenda's target rate, is $120.96.

How does Bcbsil's rate for CPT 11301 compare to Medicare?

The Bcbsil local median of $51.11 is 44% of Medicare's national non-facility rate of $116.24 for CPT 11301.

Reddenda · Rate Intelligence · Kalamazoo-Portage, MI

11301 under Bcbsil, for Kalamazoo-Portage, MI providers

Name: Bcbsil rates for CPT 11301 among Kalamazoo-Portage, MI providers
Creator: Reddenda

Shaving lesion, trunk/arms/legs, 0.6-1cm · Local peer median $51.11 · Medium confidence

$51.11 local peer median. Bcbsil's published rate file lists a local peer median of $51.11 for CPT 11301 (Shaving lesion, trunk/arms/legs, 0.6-1cm) among 409 indexed providers in Kalamazoo-Portage, MI. Where a Blue Cross entity’s label carries a state, that state names the file we found the rate in, not the provider’s location. Blue Cross plans file separately per state and do not share rates, even for the same provider. The top of that filed distribution, the P90 target, is $120.96, 137% above the median. A provider billed below this median is being paid less than peers holding the identical Bcbsil contract for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 409 providers · 414 rate records

P10

$43.44

P25

$43.44

Median

$51.11

P75

$51.11

P90 (target)

$120.96

P10$43.44

P25$43.44

Median (P50)$51.11

P75$51.11

P90 target$120.96

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $43.44 – $266.70

The local peer median for CPT 11301 under Bcbsil for Kalamazoo-Portage, MI providers is $51.11, drawn from 409 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsil to publish this rate
The bottom of the local market (P10) is $43.44 and the top (P90) is $120.96; the median-to-P90 spread is $69.85.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsil to publish this rate
The lowest published rate in this market is $43.44; the highest is $266.70.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsil to publish this rate
This benchmark is drawn from 414 individual rate records that Bcbsil itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsil to publish this rate
Medicare's national non-facility rate for CPT 11301 is $116.24, making the Bcbsil local median 44% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsil to publish this rate
50% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsil to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

409 providers bill this code to this payer in this metro.

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These are the rates Bcbsil publishes for CPT 11301 (Shaving lesion, trunk/arms/legs, 0.6-1cm) among Kalamazoo-Portage, MI providers. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Bcbsil's own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsil to publish this rate. Page generated 2026-08-23 23:45 UTC; the live index is queried in real time on every request.