CPT 11301Surgery

Shave skin lesion 0.6-1.0 cm

CPT 11301 covers the removal of a small raised skin growth (0.6 to 1.0 cm in diameter) using a shaving technique with a surgical blade. This is commonly done for moles, skin tags, warts, or other benign lesions that stick out from the skin surface.

Showing rates for

National Average

Base Medicare rate

$116.12

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

0.9

PE RVU (NF)

2.59

MP RVU

0.1

Total RVU

3.59

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

NCCI bundling edits

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Billing tips

Measure lesion diameter before local anesthesia administration and document in millimeters or centimeters, as infiltration can distort tissue and increase apparent size
Impact: Prevents downcoding from 11301 to 11300 (0.5 cm or less), protecting $26.41 in non-facility reimbursement difference
Bill each separately identifiable lesion with appropriate anatomic modifiers when multiple lesions are removed; 11301 can be reported multiple times per session
Impact: Each additional lesion generates $58.06-116.12 depending on modifier 51 application and payer policy
Send specimen for pathology examination and reference pathology report number in documentation; this supports medical necessity and may justify higher level if pathology reveals concerning features
Impact: Supports medical necessity for payer audits; reduces denial risk by approximately 15-20% based on audit data
Document exact anatomic location (e.g., 'right upper back, 5 cm lateral to midline') rather than general areas to support distinct lesions when billing multiple units
Impact: Prevents bundling denials when multiple lesions removed; can protect $232-348 when billing 3-4 lesions per session
Verify size thresholds carefully: 0.6-1.0 cm for 11301; if lesion measures 1.1 cm, bill 11302 instead for correct reimbursement
Impact: 11302 pays $141.85 non-facility vs. $116.12 for 11301, a difference of $25.73; undercoding costs money, overcoding risks audit
For Medicare patients, verify medical necessity requirements; cosmetic removal of benign lesions like skin tags may not be covered and should be identified as patient-pay in advance

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 11301 in 2025?

The 2025 Medicare national average reimbursement for CPT 11301 is $116.12 for non-facility (office) settings and $49.81 for facility settings. Actual payment may vary based on geographic locality adjustments and individual payer contracts.

How many times can I bill CPT 11301 in one day?

CPT 11301 can be billed multiple times per day for each separately identifiable lesion removed in the 0.6-1.0 cm size range. Each lesion must be documented with distinct anatomic location and size. Apply modifier 51 to secondary procedures, though many payers apply this automatically.

What is the difference between CPT 11300 and 11301?

The difference is lesion size: CPT 11300 covers shave removal of lesions 0.5 cm or less in diameter, while CPT 11301 covers lesions 0.6 to 1.0 cm. Accurate pre-procedure measurement is critical as 11301 reimburses approximately $26 more than 11300 in non-facility settings.

Does CPT 11301 require pathology examination of the specimen?

CPT 11301 does not explicitly require pathology examination, but sending specimens for pathological analysis is standard of care for most lesions and strongly supports medical necessity documentation. Some payers may deny claims for medical necessity if no pathology was performed on suspicious lesions.

Can I bill an E/M code on the same day as CPT 11301?

Yes, you can bill an E/M code with CPT 11301 on the same day if a separately identifiable evaluation and management service is performed, but you must append modifier 25 to the E/M code. The E/M must address concerns beyond the routine pre-procedure assessment for the shave removal.

How do I measure a skin lesion for proper coding of 11301?

Measure the greatest diameter of the lesion before administering local anesthesia, as anesthetic infiltration can distort tissue and artificially increase size. Document the measurement in millimeters or centimeters in the medical record. For 11301, the lesion must measure between 6mm (0.6 cm) and 10mm (1.0 cm).

What are the RVU values for CPT code 11301 in 2025?

The 2025 RVU values for CPT 11301 are: Work RVU 0.9, Non-Facility PE RVU 2.59, Facility PE RVU 0.54, and Malpractice RVU 0.1, for a total non-facility RVU of 3.59. These are multiplied by the conversion factor of 32.3465 to determine Medicare payment.