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CPT 11102: Tangential (Shave) Biopsy of Single Skin Lesion
CPT code 11102 denotes a tangential (shave) biopsy of a single skin lesion, a common diagnostic procedure used to remove superficial skin growths for histopathologic evaluation. Nationally, shave biopsies are routine across dermatology and primary care settings and affect utilization, documentation, and coding practices for skin lesion workups. Coverage, coding edits, and payment policies for shave biopsies influence outpatient surgical workflows and pathology referral patterns.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise briefing on payer coverage considerations, common billing relationships to related codes, and the clinical context in which 11102 is typically reported. The publication outlines benchmarks and policy-relevant points such as when shave biopsy is the appropriate technique versus other biopsy types and how that status translates into coding and claim submission.
This overview equips revenue cycle, clinical billing, and compliance teams with the essentials: what CPT code 11102 represents, where it is normally performed, and which national payers are relevant to its reimbursement and administrative handling. Data not available in the input for specific regional policies or payer-specific fee schedules.
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Billing Code Overview
CPT code 11102 describes a tangential (shave) biopsy of a single skin lesion. The procedure involves shaving off or scooping out the lesion with a knife or curette using a side-ways approach to obtain tissue for diagnostic evaluation.
Service type: Skin biopsy — tangential/shave technique
Typical site of service: Office or outpatient dermatology clinic
National Reimbursement Benchmarks
Medicare's mean allowed amount of $99.3 sits below BUCA's average commercial mean of $202.7, indicating Medicare reimbursement is roughly half of the BUCA commercial benchmark for CPT 11102. This gap highlights how commercial arrangements can push mean rates substantially above the Medicare baseline, with BUCA representing a higher-average commercial outcome compared with Medicare's more centralized schedule.
Comparing dispersion (P75 minus P25) across payers, Blue Cross Blue Shield has the widest interquartile spread at $115.2 ($340.7 - $219.5), followed by UnitedHealth Group at $93.6 ($170.5 - $77.9) and BUCA at $106.4 ($256.0 - $149.6). The tightest spreads belong to Aetna at $72.4 ($110.1 - $36.2) and Cigna at $93.1 ($148.4 - $54.9). These differences indicate substantial variation in mid‑range commercial pricing by payer, with Blue Cross Blue Shield showing the largest middle‑50% variability.