CPT 11310: Shaving of Single Epidermal or Dermal Lesion ≤0.5 cm (Face/Mucosa) - OpenPayer

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Summary & Overview

CPT 11310: Shaving of Single Epidermal or Dermal Lesion ≤0.5 cm (Face/Mucosa)

CPT code 11310 covers shaving of a single epidermal or dermal lesion 0.5 cm or less in diameter located on cosmetically sensitive areas such as the face, ears, eyelids, nose, lips, or mucous membranes. This code captures a common minor dermatologic destructive procedure with national relevance due to its frequency in outpatient dermatology and primary care settings and its implications for coding accuracy, payment adjudication, and clinical documentation. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical scope and sites of service, typical payer coverage considerations, common modifiers used in practice, and related coding contexts. The publication outlines benchmarks and reimbursement context where available, highlights coding and documentation elements that affect claims processing, and summarizes clinical scenarios that commonly map to this code. Data not available in the input is noted where applicable. This resource is intended to help coding, billing, and clinical staff understand the purpose and proper use of CPT code 11310 in national practice settings.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare11310CPTdermatologylesion shavingminor procedureoutpatientprocedure codingskin lesion

Billing Code Overview

CPT code 11310 describes the shaving of a single epidermal or dermal lesion measuring 0.5 cm or less in diameter from the face, ears, eyelids, nose, lips, or mucous membranes. This procedure is a minor skin lesion removal technique performed by a qualified provider.

Service type: Destructive/Excisional Dermatologic Procedure (lesion shaving)

Typical site of service: Outpatient clinic or office-based dermatology or surgical setting, including procedures performed on the face, ears, eyelids, nose, lips, or mucous membranes.

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 nose measuring 0.4 cm in greatest diameter. The lesion is clinically suspected to be a benign epidermal lesion (e.g., intradermal nevus or seborrheic keratosis) and the clinician elects to perform a shave biopsy with a blade to remove the visible portion of the lesion for both therapeutic and diagnostic purposes. Local anesthesia (infiltration of lidocaine with epinephrine) is administered. The procedure is performed in a minor procedure room; the specimen is labeled and sent to pathology for histologic evaluation. The visit includes pre-procedure evaluation, consent, the shaving procedure of a single lesion 0.5 cm or less on the nose, and brief post-procedure wound care instructions. Typical documentation includes lesion location, size, method (shave), anesthesia, specimen handling, estimated blood loss, and follow-up plan. Payors commonly involved include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable E/M service by the same physician on the same day as the procedure	Use when an evaluation and management visit is separately documented and medically necessary in addition to the shave procedure.

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Taxonomy Code	Specialty	Notes
207N00000X	Dermatology	Dermatologists frequently perform shave biopsies and removals of epidermal/dermal lesions.
208000000X	Otolaryngology (ENT)	ENT surgeons manage lesions on the nose, lips, and mucous membranes when indicated.
207R00000X	Family Medicine	Primary care physicians often perform minor skin procedures in-office including shaves of small lesions.
208600000X	Plastic Surgery	Plastic surgeons may perform shave or excision procedures on cosmetically sensitive facial areas.
207L00000X	General Surgery	General surgeons in some settings perform minor skin procedures, particularly in ambulatory surgical centers.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L82.1`	Seborrheic keratosis	Common benign epidermal lesion often removed by shave when symptomatic or for diagnosis.
`D22.9`	Melanocytic nevi, unspecified	Benign nevus that may be sampled or removed by shave biopsy for diagnostic evaluation if clinically indicated.
`L91.8`	Other hypertrophic disorders of skin	Includes raised benign lesions where shave removal may be performed for comfort or cosmetics.
`L98.0`	Pyogenic granuloma	Small vascular lesion that can be treated with shave removal or tangential excision.
`R23.3`	Spontaneous ecchymosis	Relevant when lesion presents with bleeding or crusting prompting removal and evaluation.
`C44.9`	Skin cancer, unspecified	When malignancy is suspected and a diagnostic/treatment shave is performed; definitive cancer codes assigned after pathology.
`L57.0`	Actinic keratosis	Premalignant lesion often treated or sampled; shave removal may be used in some presentations.
`B08.9`	Viral wart, unspecified	Cutaneous wart lesions sometimes treated with shave or tangential removal when refractory to other therapies.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11300`	Shaving of epidermal or dermal lesion, single lesion, trunk, arms, or legs; diameter 0.5 cm or less	Alternative anatomic-site-specific shave code for non-facial lesions; used when lesion location is trunk/arms/legs rather than face/ears/eyelids/nose/lips/mucous membranes.
`11311`	Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, or mucous membranes; diameter 0.6 to 1.0 cm	Used when the lesion diameter exceeds 0.5 cm and falls into the next size category for facial sites.
`11102`	Tangential biopsy of skin (e.g., shave), single lesion	Sometimes used in documentation and payer adjudication for diagnostic shave biopsies; relates as an alternative coding approach depending on payer guidance.
`11100`	Biopsy of skin, single lesion, any method	General skin biopsy code that may appear in the workflow if payer or documentation supports a biopsy rather than a procedure code for removal.
`11101`	Biopsy of skin, multiple lesions	Used when multiple shave biopsies/lesions are sampled in the same session and billed per lesion.
`99024`	Postoperative follow-up visit, global period	Used when a routine follow-up visit falls within the global surgical period for minor procedures, as applicable.