Summary & Overview
CPT 11301: Shave Removal of Epidermal or Dermal Lesion 0.6–1.0 cm
CPT code 11301 covers the shave removal of a single epidermal or dermal skin lesion 0.6–1.0 cm in diameter from the trunk, arms, or legs. This minor dermatologic surgical code is commonly used in outpatient and ambulatory dermatology settings for removal of lesions for therapeutic or diagnostic purposes. Nationally, accurate use of 11301 matters for clinical documentation, coding consistency, and appropriate claims processing for skin procedures.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an explanation of the clinical context for the service, comparisons of coding practice and reimbursement benchmarks across major payers, and notes on documentation elements that typically support medical necessity for minor dermatologic procedures. The analysis highlights expected settings of care, common clinical indications, and how 11301 fits within the spectrum of skin lesion excision codes.
The publication provides concise benchmarks, coding considerations, and policy updates affecting billing for minor skin surgery to inform clinicians, billing professionals, and policy analysts working at a national level.
Billing Code Overview
CPT code 11301 describes the surgical removal by shave technique of a single epidermal or dermal lesion measuring 0.6 cm to 1.0 cm in diameter from the skin of the trunk, arms, or legs. This procedure is a minor cutaneous surgical service performed to remove benign or diagnostic skin lesions.
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Service type: Excisional skin procedure (shave removal of a single epidermal or dermal lesion)
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Typical site of service: Outpatient clinic, dermatology office, or ambulatory surgical setting on the trunk, arms, or legs
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient presents to an outpatient dermatology clinic with a solitary, raised pigmented papule on the lateral forearm measuring approximately 0.8 cm in greatest diameter. The lesion has been present for several months and the clinician determines that a diagnostic and therapeutic shave removal is appropriate. After informed consent, the medical assistant documents allergies and medications, and the clinician photographs and marks the site. Local infiltration with 1% lidocaine with epinephrine is performed. Using a curette or scalpel held tangentially, the clinician performs a shave excision limited to the epidermis and superficial dermis to remove the lesion in one pass. Hemostasis is attained with electrocautery or chemical cautery. The specimen is placed in formalin and labeled for pathology if pathology submission is indicated. Procedure documentation includes lesion size (0.6–1.0 cm), anatomic location on the trunk, arms, or legs, anesthesia used, technique (single lesion shave), estimated blood loss (usually minimal), and pathology/send-out instructions if performed. Typical sites of service are outpatient dermatology clinic, ambulatory surgical center, or physician office-based procedure room. Common personnel involved include the dermatology provider (physician or advanced practice provider), medical assistant or nurse, and pathology courier when needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable E/M service on the same day | Use when a distinct office visit or evaluation is performed in addition to the shave procedure. |
59 | Distinct procedural service | Use to indicate a procedure is distinct or separate from another service performed on the same day when not reportable with a modifier like XS. |
51 | Multiple procedures | Use when multiple procedures are performed during the same session and payer requires coding for multiple procedures. |
52 | Reduced services | Use when the procedure is partially reduced or discontinued. |
50 | Bilateral procedure | Rare for single lesion shave; use if symmetrical paired lesions are shaved and payer accepts bilateral modifier for the code. |
53 | Discontinued procedure | Use when the procedure is started but halted due to patient factors. |
59 | Distinct procedural service | Use to indicate a procedure is distinct from other services on the same date (duplicate intentionally not repeated in claim; see payer policy). |
26 | Professional component | Use when billing only the professional component separate from technical component (uncommon for simple shave in office). |
RT | Right side | Use when lateralizing the service to the right side for payers that require laterality. |
LT | Left side | Use when lateralizing the service to the left side for payers that require laterality. |
52 | Reduced services | Use for significant reduction in service (duplicate entry avoided by payer rules). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207N00000X | Dermatology | Dermatologists most commonly perform shave excisions for diagnostic and therapeutic removal. |
207P00000X | Dermatopathology | Dermatopathologists receive and interpret specimens from shave procedures. |
208000000X | Family Medicine | Family physicians may perform office-based shave excisions for benign-appearing lesions. |
363L00000X | General Surgery | General surgeons may perform cutaneous procedures including shave removal in some practice settings. |
208D00000X | Internal Medicine | Hospital-based or clinic internists may perform simple skin lesion removals in select settings. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
L72.0 | Epidermal inclusion cyst | Common benign lesion that may be removed by shave if superficial and appropriate. |
L82.0 | Seborrheic keratosis | Frequently treated with shave excision for symptomatic or diagnostic removal. |
D22.9 | Melanocytic nevus, unspecified | Benign mole that may be shaved for diagnostic evaluation when superficial. |
L21.9 | Contact dermatitis, unspecified | Not a common indication for shave; included only if a lesion requires sampling to exclude other pathology. |
R23.8 | Other skin changes | Used when nonspecific skin lesions require sampling via shave for diagnosis. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11300 | Shaving of epidermal or dermal lesion, trunk, arms, or legs; diameter 0.5 cm or less | Represents a smaller lesion size category; used when lesion is ≤0.5 cm instead of 11301. |
11302 | Shaving of epidermal or dermal lesion, trunk, arms, or legs; diameter 1.1 to 2.0 cm | Represents the next size increment for lesions larger than the 11301 range. |
11400 | Excision, benign lesion including margins, trunk, arms, or legs; 0.5 cm or less | An excision code used when full-thickness removal with closure is performed rather than a shave technique. |
11100 | Tangential biopsy of skin (e.g., shave, scoop), single lesion | Often used interchangeably in some payer policies; documents tangential biopsy techniques similar to shave. |
11101 | Tangential biopsy, each additional lesion (List separately in addition to code for primary procedure) | Used when multiple tangential biopsies/shave lesions are performed in the same session. |
17000 | Destruction (e.g., laser; electrosurgery, cryotherapy) of benign lesions, up to 14 lesions | May be performed instead of shave excision for certain benign lesions when destruction rather than removal is chosen. |