Summary & Overview
CPT 11306: Shave Excision of Single Skin Lesion 0.6–1.0 cm
Headline: CPT code 11306 covers shave excision of a single small skin lesion, commonly used in dermatology and outpatient surgical care.
Lead: CPT code 11306 represents the shave removal of a single epidermal or dermal lesion measuring 0.6 to 1.0 cm in diameter, typically performed on the scalp, neck, hands, feet, or genitals. This code captures a frequently performed, low-complexity skin procedure with implications for outpatient surgical workflow and payer coverage policies nationally.
Why it matters: Shave excisions address common dermatologic complaints and are used both for diagnostic pathology and for therapeutic lesion removal. Accurate coding affects clinical documentation, pathology routing, and payment across major commercial payers and Medicare.
Payers covered: Analysis includes major national payers — Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: The publication summarizes clinical context for use of CPT code 11306, identifies typical sites of service, and outlines common payer coverage considerations and benchmarking topics relevant to outpatient dermatologic procedural billing. Where available, readers will find comparisons of reimbursement patterns and policy updates that affect shave excision coding and claim adjudication. Data not available in the input will be noted as such.
Billing Code Overview
CPT code 11306 describes the surgical removal by shaving of a single epidermal or dermal lesion measuring 0.6 to 1.0 cm in diameter. This procedure involves superficial removal of a skin lesion down to the level of the dermis and is commonly performed for diagnostic or therapeutic purposes.
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Service type: Skin lesion shave excision (superficial lesion removal)
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Typical site of service: Scalp, neck, hands, feet, or genitals (ambulatory clinic, dermatology office, or outpatient surgical setting)
Data not available in the input for ICD-10 diagnoses, associated taxonomies, or related codes.
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient presents to a dermatology clinic with a solitary, symptomatic pigmented papule on the dorsal scalp measuring approximately 0.8 cm in greatest diameter. The lesion is clinically suspicious for an epidermal inclusion cyst versus a benign nevus and is causing local irritation under the patient’s hair. After informed consent, the dermatologist performs a shave excision of the single epidermal/dermal lesion under local infiltration with lidocaine. The specimen is labeled and submitted to pathology for microscopic evaluation. Hemostasis is achieved with electrocautery and the wound is dressed; the patient is given wound care instructions and scheduled for a pathology follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service on the same day | When the provider documents a distinct E/M visit for a condition separate from the lesion removal prior to performing the shave. |
59 | Distinct procedural service | When another procedure on a different lesion or anatomical site is performed the same day and documentation supports distinct services. |
51 | Multiple procedures | When additional unlisted or other procedures are performed the same session and payer requires reporting of multiple procedures. |
52 | Reduced services | When the procedure is partially reduced or not completed as originally planned (e.g., aborted size or depth). |
53 | Discontinued procedure | When the procedure is terminated due to extenuating circumstances or patient request after anesthesia or prep. |
22 | Increased procedural services | When the work, time, or complexity substantially exceeds typical expectations and documentation supports unusual services. |
26 | Professional component | If reporting only the professional component separate from a technical component (rare for simple excisions; included for completeness). |
RT | Right side | When the lesion is on the right side of a paired organ or site and laterality reporting is required. |
LT | Left side | When the lesion is on the left side of a paired organ or site and laterality reporting is required. |
59 | Distinct procedural service | Use when a different lesion on the same day requires separate coding and no more specific modifier applies. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207N00000X | Dermatology | Most common specialty performing shave excisions of epidermal/dermal lesions. |
2080S0125X | Family Medicine | Family physicians frequently perform minor skin procedures in office settings. |
207L00000X | General Surgery | Surgeons may perform shave or excision procedures in clinic or OR for selected lesions. |
362W00000X | Plastic Surgery | Plastic surgeons perform lesion removal when reconstruction or complex closure is anticipated. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
L98.9 | Disorder of skin and subcutaneous tissue, unspecified | Non-specific coding when an exact diagnosis is not yet established; may be used prior to pathology results. |
L73.9 | Follicular disorder of skin, unspecified | Used for benign follicular lesions such as epidermal inclusion cysts that may be shaved. |
L82.1 | Seborrheic keratosis, unspecified | Common benign epidermal lesion frequently removed for symptoms or cosmetic reasons. |
D22.9 | Melanocytic nevus, unspecified | Benign nevus that may be treated with shave removal when clinically appropriate. |
L30.9 | Dermatitis, unspecified | Inflamed benign lesions or excoriated papules that may be treated with shave procedures for diagnosis or symptom relief. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11300 | Shaving of skin lesion(s); single lesion, trunk, arms or legs, lesion diameter 0.5 cm or less | Alternative shave code for smaller lesions; used when lesion size falls below the 11306 size range. |
11305 | Shaving of skin lesion(s); single lesion, scalp, neck, hands, feet, or genitals, lesion diameter 0.5 cm or less | Procedure on similar anatomy for smaller lesions; used when lesion diameter is ≤ 0.5 cm. |
11308 | Shaving of skin lesion(s); single lesion, trunk, arms or legs, lesion diameter 1.1 to 2.0 cm | Used when lesion on extremities/trunk is larger than the 11306 size range and anatomical site differs. |
11102 | Tangential biopsy of skin; single lesion | Diagnostic biopsy technique related to shave techniques; used when provider performs a tangential biopsy rather than a therapeutic shave. |
11400 | Excision of benign lesion including margins, trunk, arms, legs; lesion diameter 0.5 cm or less | Represents full-thickness excision alternative when clinical judgment favors excision with margins rather than a shave. |