Mohs micrographic surgery (MMS) is widely used, but there is a lack of information on how the level of experience a surgeon has with MMS impacts how often they use it. The goal of this study is to compare the MMS utilization rates of novice and seasoned surgeons. The physicians who billed Medicare for more than or equal to 200 Mohs surgery procedures each year were included in this cross-sectional study that analyzed data from 2012 through 2018. The major measure was the mean yearly claims for Mohs surgery among doctors with varying levels of experience. Flaps/grafts and the use of oral antibiotics, benzodiazepines, and opioids were secondary outcomes. The mean number of Mohs surgeries performed annually (95% CI) by each of the 1,759 individual surgeons was highest among those with 16-20 years of expertise (578.7 [556.7–600.6]). The most antibiotics were written by surgeons with 21-25 years of experience (240.2 [216.5-263.8] mean annual claims), while the longest courses were written by surgeons with more than 35 years of experience (15.3 [14.2–16.4] days). Surgeons who were in the middle of their careers did the most mean annual Mohs surgeries, while surgeons who were further along in their careers administered more frequent and longer courses of antibiotics, indicating a shift in practice patterns with more years of experience.