CPT 11303Surgery

Shave skin lesion >2.0 cm

CPT code 11303 covers the removal of a skin growth or lesion larger than 2 centimeters (about the size of a grape) using a shaving technique that doesn't require stitches. The lesion is sliced off at skin level using a sharp blade, and the specimen is typically sent to pathology for examination.

Showing rates for

National Average

Base Medicare rate

$146.21

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

1.25

PE RVU (NF)

3.12

MP RVU

0.15

Total RVU

4.52

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

NCCI bundling edits

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Billing tips

Always measure the lesion's greatest diameter before removal and document in the procedure note. The >2.0 cm threshold is what separates 11303 ($146.21) from 11302 ($115.87), a difference of $30.34 per lesion.
Impact: $30.34 revenue loss per lesion if downcoded due to insufficient size documentation; multiply by annual volume for total impact
Bill multiple units of 11303 when removing multiple lesions >2.0 cm on the same date. Each separate lesion should be documented with its own size and location. Medicare allows payment for multiple units without a cap.
Impact: Full reimbursement of $146.21 per lesion (non-facility); failure to bill separate units leaves significant revenue on the table
The non-facility rate ($146.21) applies when performed in office settings; facility rate ($69.22) applies in hospital outpatient departments or ASCs. Verify your place of service code (11 vs 22/24) matches actual location.
Impact: $76.99 difference per procedure between settings; incorrect POS codes trigger audits and recoupment
Include pathology result documentation in the medical record. Even though pathology is billed separately (88305 for most shave specimens), linking the clinical impression to pathologic diagnosis supports medical necessity and reduces audit risk.
Impact: Reduces denial rate by 15-25% based on specialty audits; strengthens appeal position if medical necessity is questioned
For lesions measuring exactly 2.0 cm, code as 11302 (1.1-2.0 cm), not 11303. The descriptor states '>2.0 cm' meaning greater than, not equal to. Document measurements to the nearest millimeter (e.g., 2.1 cm, 2.2 cm).
Impact: Prevents upcoding allegations and prepayment review flags; protects against OIG scrutiny and potential fraud allegations

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Frequently asked questions

What is the Medicare reimbursement for CPT code 11303 in 2025?

The 2025 Medicare national average reimbursement for CPT 11303 is $146.21 in non-facility settings (office/clinic) and $69.22 in facility settings (hospital outpatient department or ASC). Actual payment may vary based on geographic locality adjustments using the GPCI (Geographic Practice Cost Index) for your area.

How many RVUs is CPT code 11303 worth?

CPT 11303 has a total of 4.52 RVUs for 2025, broken down as: 1.25 work RVUs, 3.12 practice expense RVUs (non-facility), 0.74 practice expense RVUs (facility), and 0.15 malpractice RVUs. The conversion factor of 32.3465 is applied to total RVUs to calculate the dollar reimbursement.

What size lesion qualifies for CPT code 11303?

CPT 11303 is used for shave removal of lesions with a diameter greater than 2.0 cm (larger than 2.0 cm, not equal to). Lesions measuring exactly 2.0 cm or smaller should be coded as 11302 (1.1-2.0 cm) or 11301 (0.6-1.0 cm). Measurement should be the greatest clinical diameter documented before removal.

Can I bill multiple units of CPT 11303 on the same day?

Yes, you can bill multiple units of CPT 11303 when removing multiple separate lesions that each measure >2.0 cm on the same date of service. Each lesion must be documented individually with its own size measurement and anatomic location. Use anatomic modifiers (LT/RT, digit modifiers) when appropriate to distinguish between lesions and prevent bundling denials.

What is the difference between CPT 11303 and excision codes 11400-11406?

CPT 11303 is a shave removal performed tangentially at skin level without full-thickness excision, typically not requiring closure or using simple closure with adhesive or single-layer sutures. Excision codes (11400-11406) involve full-thickness removal through the dermis into subcutaneous tissue with layered closure. Excision codes generally reimburse higher but require more extensive procedures and documentation.

Do I need modifier 25 to bill an E/M with CPT 11303?

Yes, modifier 25 is required on the E/M code when billing a significant, separately identifiable evaluation and management service on the same day as the shave removal (11303). The E/M documentation must demonstrate work beyond the decision to perform the procedure, such as evaluation of other conditions, comprehensive history for a new patient, or management of unrelated problems.

What documentation is required to support billing CPT 11303?

Required documentation includes: pre-removal lesion measurement showing >2.0 cm diameter, specific anatomic location, clinical description of the lesion, medical indication for removal, technique and method of hemostasis used, specimen disposition to pathology, and patient toleration. The measurement must be documented before removal, as post-removal measurements are not acceptable for code selection.