CPT 11300Surgery

Shave skin lesion 0.5 cm/<

CPT code 11300 is used when a healthcare provider shaves off a small skin growth or lesion (less than 0.5 centimeters in diameter) using a blade or similar tool. This is a simple office procedure that removes the raised portion of the lesion without deep cutting or stitches.

Showing rates for

National Average

Base Medicare rate

$95.42

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.6

PE RVU (NF)

2.29

MP RVU

0.06

Total RVU

2.95

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Measure and document lesion size precisely before removal, not after. Post-removal specimens often measure differently due to tissue contraction or expansion in formalin.
Impact: Accurate size documentation prevents downcoding from 11301 ($126.15) to 11300 ($95.42), a $30.73 loss per lesion. Over 100 procedures annually, this represents $3,073 in potential revenue.
Bill based on place of service correctly: POS 11 (office) yields $95.42 vs. POS 22 (outpatient hospital) yields $32.67. Verify your facility registration status with Medicare.
Impact: Incorrect POS coding can result in $62.75 underpayment per procedure or trigger recoupment if facility rate paid when non-facility services provided
When removing multiple lesions, bill each separately with appropriate quantity. Do not use units >1 on a single line; instead use separate line items for each lesion.
Impact: Multiple lesions coded correctly with modifier 51 (automatic for most payers): first lesion $95.42, second $47.71, third $47.71. Four lesions = $238.55 vs. common error of billing only once = $95.42 loss of $143.13
Link appropriate ICD-10 codes that support medical necessity. Avoid cosmetic diagnoses (L82.1 for seborrheic keratosis may require specific documentation of irritation or bleeding).
Impact: Medically necessary lesion removal reimbursed at $95.42; cosmetic denial results in 100% loss or patient balance billing issues
Do NOT bill local anesthesia (CPT 64400-series or HCPCS codes for anesthetic agents) separately with 11300, as it is included in the procedure payment.
Impact: Separate anesthesia billing triggers bundling denials and can flag practice for audit. Avoiding this error prevents 100% denial of the anesthesia charge plus potential compliance review.

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 11300 in 2025?

The 2025 Medicare national average reimbursement for CPT 11300 is $95.42 for non-facility (office) settings and $32.67 for facility settings. These rates are based on total RVUs of 2.95 (Work: 0.6, PE Non-Facility: 2.29, PE Facility: 0.35, MP: 0.06) multiplied by the 2025 conversion factor of 32.3465. Actual reimbursement may vary by geographic locality.

Can I bill an E/M visit with CPT 11300 on the same day?

Yes, you can bill an E/M service with 11300 on the same day, but you must append modifier 25 to the E/M code and document that the E/M was a separately identifiable service. The documentation must show that the decision to perform the shave removal was made during the E/M, or that the E/M addressed problems beyond the lesion removal procedure itself.

What is the size limit for billing CPT 11300?

CPT 11300 is used for lesions 0.5 cm or less in diameter. The measurement must be documented before removal. Lesions 0.6-1.0 cm should be coded as 11301, 1.1-2.0 cm as 11302, and over 2.0 cm as 11303. Using the wrong code based on size can result in significant reimbursement differences.

How do I bill for multiple skin lesion removals on the same day?

Bill each lesion removal as a separate line item with the appropriate CPT code based on each lesion's size. Most payers automatically apply modifier 51 (multiple procedures) and reimburse the highest-value procedure at 100% and additional procedures at 50%. List each lesion with its specific anatomic location in the documentation.

Is pathology included in CPT 11300 reimbursement?

No, pathology services are billed separately by the pathology laboratory using CPT 88305 (surgical pathology, gross and microscopic examination) for most skin lesion specimens. CPT 11300 covers only the shave removal procedure itself. The performing provider and pathology lab bill separately for their respective services.

What ICD-10 codes support medical necessity for CPT 11300?

Medically necessary diagnoses include D22.x (melanocytic nevi with concerning features), D23.x (other benign skin neoplasms), L82.0 (inflamed seborrheic keratosis), L57.0 (actinic keratosis), and L98.9 (skin disorder with bleeding/irritation documented). Purely cosmetic diagnoses like L82.1 (uncomplicated seborrheic keratosis) may result in denials unless symptoms are clearly documented.

What is the global period for CPT 11300?

CPT 11300 has a 10-day global period. This means all routine post-procedure care within 10 days of the procedure is included in the reimbursement and cannot be billed separately. Complications or unrelated services during this period may be billed with appropriate modifiers (24 for unrelated E/M, 78 for related return to OR).