CPT 11306Surgery

Shave skin lesion 0.6-1.0 cm

CPT 11306 covers the removal of a skin lesion (such as a mole, wart, or growth) by shaving it off at skin level when the lesion measures between 0.6 and 1.0 centimeters in diameter. This is a surface-level removal technique that does not go deep beneath the skin.

Showing rates for

National Average

Base Medicare rate

$116.77

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

0.96

PE RVU (NF)

2.57

MP RVU

0.08

Total RVU

3.61

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Measure lesion size before anesthesia injection or removal, as infiltration can artificially enlarge the lesion and lead to upcoding accusations
Impact: Prevents compliance risk and potential recoupment; measurement documentation protects against downcoding from 11306 ($116.77) to 11305 (lower rate)
Bill each lesion removal separately with the appropriate CPT code based on individual lesion size; list the largest/most complex procedure first to maximize reimbursement under multiple procedure reduction rules
Impact: First lesion pays 100% ($116.77), subsequent lesions typically reduced to 50% ($58.39); proper sequencing maximizes total payment
Verify place of service code matches actual location: POS 11 (office) triggers non-facility rate of $116.77 while POS 22 (hospital outpatient) or 24 (ASC) triggers facility rate of $46.90
Impact: Incorrect POS coding results in $69.87 underpayment per procedure and may trigger prepayment review or audit
Document the medical necessity for removal (e.g., changing characteristics, symptomatic, rule out malignancy) rather than cosmetic reasons, as cosmetic removals are patient-pay
Impact: Medical necessity documentation is the difference between full reimbursement and complete denial; cosmetic procedures are contractually non-covered
Link appropriate ICD-10 codes that reflect the clinical indication (D22.x for benign nevi, D23.x for other benign skin neoplasms, L82.x for seborrheic keratosis); avoid unspecified codes
Impact: Specific diagnosis coding reduces claim review probability and supports medical necessity; unspecified codes may trigger denials or requests for records

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 11306?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT 11306 in 2025?

The 2025 Medicare national average non-facility rate for CPT 11306 is $116.77, while the facility rate is $46.90. The non-facility rate applies when performed in an office setting, while the facility rate applies in hospital outpatient departments or ambulatory surgery centers where the facility bills separately for overhead costs.

How many RVUs is CPT code 11306 worth?

CPT 11306 has a total of 3.61 RVUs, consisting of 0.96 work RVUs, 2.57 non-facility practice expense RVUs (0.41 facility PE RVUs), and 0.08 malpractice RVUs. These values are from the CMS 2025 Medicare Physician Fee Schedule.

Can I bill an E/M visit with CPT 11306 on the same day?

Yes, you can bill an E/M service with CPT 11306 on the same day using modifier 25, but only if the E/M represents a separately identifiable service beyond the usual pre-procedure and post-procedure work. Documentation must clearly show a distinct evaluation that would justify an E/M visit independent of the decision to perform the shave removal.

What size lesion is coded with CPT 11306?

CPT 11306 is used for shave removal of skin lesions measuring 0.6 to 1.0 centimeters in diameter. The measurement should be taken at the greatest clinical diameter before any local anesthesia is administered. Lesions 0.5 cm or smaller use 11305, while lesions 1.1 to 2.0 cm use 11307.

Does CPT 11306 include pathology examination?

No, CPT 11306 covers only the shave removal procedure itself. If the specimen is sent to pathology for examination, you must bill the appropriate pathology CPT code separately (typically 88305 for surgical pathology, gross and microscopic examination). The pathology service is usually billed by the pathologist or laboratory, not the performing physician.

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

Bill each lesion removal separately using the appropriate CPT code based on individual lesion size. List procedures in descending RVU order, with the highest-valued procedure first. Most payers apply multiple procedure reduction, paying 100% for the first procedure and 50% for additional procedures. Use modifier 59 or XS if needed to override inappropriate NCCI bundling edits for distinct lesions.

What is the difference between CPT 11306 and 11406?

CPT 11306 describes a shave removal (horizontal slicing at or through the dermis level), while CPT 11406 describes excision (full-thickness removal through the subcutaneous tissue with layered closure) of a benign lesion including margins, trunk/arms/legs, lesion diameter 1.1 to 2.0 cm. Code 11406 involves deeper removal, typically requires suturing, and has higher reimbursement due to greater complexity and work.